1463 Pond Wynde NPERMIT
City of Eagan Permit Type:Building
Permit Number:EA128042
Date Issued:10/23/2014
Permit Category:ePermit
Site Address: 1463 Pond Wynde N
Lot:8 Block: 3 Addition: Deerwood Ponds
PID:10-19975-03-080
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 .
Scott Rise
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 -
Wilfred Wong
1463 Pond Wynde N
Eagan MN 55122
Lakewoods Remodeling
9001 E Bloomington Freeway #144
Bloomington MN 55420
(952) 888-5550
Applicant/Permitee: Signature Issued By: Signature
City of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
r
Use BLUE or BLACK Ink
Permit#: "r'
Permit Fee: `j
Date Received:
Staff:
L
2010 MECHANICAL PERMIT APPLICATION
Date: 2 - Z- ( 0 Site Address: Z LE 6 3 6 n
Tenant: &_) c' 11.J 0
food
Suite #:
RESIDENT / OWNER
Name:
-c)
Address / City / Zip: ) Lk6 3 ?o
Phone: 6, s I bsit t�
CONTRACTOR
Name:
ESIDENTIHL HEATING & AIR, INC
Address: 1815 East 41st Street, Suite A City:
Minneapolis, MN 55407-3425
State: Zip: (612) 729-9151 Phone:
License #:
Contact:
Email:
TYPE OF WORK
PERMIT TYPE
New .7( Replacement
Additional
Alteration
Demolition
Description of work:
RESIDENTIAL
Furnace
Air Conditioner
Air Exchanger
Heat Pump
Other
New Construction
Install Piping
Gas
COMMERCIAL
Interior Improvement
Processed
Exterior HVAC Unit
Under / Above ground Tank (_ Install / Remove)
** When installing/removing tank(s), call for inspection by Fire
Marshal and Plumbing Inspector
RESIDENTIAL FEES:
$55.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge)
$95.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge)
$ 5s a0
TOTAL FEE
COMMERCIAL FEES:
$75.00 Underground tank installation/removal
$55.00 Minimum (includes State Surcharge)
OR
- If the Permit Fee is Tess than $10,010, surcharge is $ 5.00
- If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee
(i.e. a $10,010-$11,010 Permit Fee requires a $ 5.50 surcharge)
Contract Value $ x 1%
_ $ Permit Fee
= $ Surcharge
_ $ TOTAL FEE
CALL BEFORE YOU DIG. can Gopher State One Call at (651) 454-0002 for protection against underground utility damage. CaII 48 hours
before you intend to dig to receive locates of underground utilities. www.Aopherstateonecall.orq,
I hereby acknowledge that this information is complete and accurate; that the work will be in nfomiance 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 start wit f oyt a pt nit; that the work will be in accordance
with theroved plan in the case of work which requires a review and approval of plans.
x
Applicant's Printed Name
Applicar}rt'sISigna ture
' CI 7Y OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 5512::
(612) 681-4675
SITE ADDRESS:
J4b3
PERMIT SUBTYPE:
INSPECTIQN RECORD
PERMIT TYPE:
Permit Number:
Date Issued:
1117" n APPLICANT:
YFllll N
\ TYPE OF WORK:
iJ i
, .$
INSPECTION DA • D•
t fJ i'1 W.
, t iJA!
& w I, iLs+r 1,1 nI? NI H iti
? ? J
Permit No. Permft Holder Dffie Telephone N
SNV
PLUMBING ? ,5 75rf - ya?
HVAC ?I qG?'II?OL/
ELECTRI aa Q
ELECTRIC
Inspectfon Dats Insp. CommeMa
Footingsl
71-1-'1-4/u -?(
Foundation 2 ?
Framing ? ariG- ? rt e.?. w/
Y? ? io ti $ °
Rooting
Rough Plbg.
Rough Htg. .. C?/ -.1p/
l5ul.
Faepiace y 1 ! ?v oz - 3' ?- y s?i - D
V 2/ 41 - _ NoT y?
Final Htg. -Y _I?
/ J ?
Orsat Test n
Final Plbg.
.? Pibg. Inspecta - Notity Plumber
Const. Meter
Engr./Plen
Bldg. Flnal
Dedc Ftg.
Deck Final
weii
Pr. Disp.
v
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Wertificate nt CccupancV
Wit4 af eagan
MO artmtent ? 1340ing aa#ocction
This Cerlejecate issued pursuani ta the ?equrrements of the Uniforrrr Building Code
certifying that at the time of issuance thu stntcture was in compliance with the various
ordinances of tiie City ngulating building construction or use. For the followrng:
Use Qassificafion: ST M Bag. Permu No. =2 !
pcapaocY Type R3/"L I 7ming puma PD Typc Const. VN
own,erorsoiwing .][11.IK & AHEMAMS andness 1631 DEEReOf'D PAIU, F,l1GMt
Bwi&.oa Aaamm 1463 POM wYNEE MXM tocai;ry i8,.g3- r?rrncim pR
?
nate:
eWWiag aFicial
POST IN A CONSPICUOUS PLACE
Address 1463 PCRID taYeIDE rpxlx Zip 5512 2
Lpt , s Blk 3 Sub
DEQbAOD P(X`IDS
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECI'ION.
Date: WN Yes No Inspector: uj- -
Final grade (6" f;om siding) ?
Permanent steps (gazage) ?
Pennanent steps (main entry) ?
Permanent dtiveway ?
Permanent gas ?
Sod/Seeded gass
TraiUcurb damage
Porch ?
Basement finish ?
Deok
Please verify with the builder the removal of roof tesf caps from the plumbing system and the shut-off of wafer supply to
the autside lawp faucet before freeze potential exists.
Contact engineering division at 681-4645 before working in rightof-way or installing underground sprinkler system. ?
Wfiite - City Copy Yellow - Resident Copy Pink - Contractor Copy
? OG/?yb Gi?l19?f
? 8 6 q?7G5G }` ?? 9
Revues Date
? Fire No. Rmg?-In Inpsedron ReQUIreA
(YOU must II inspactor when ready)
Yes o Inspeclion Other Than Rough-ln
0 Reatly Now ? Will Notily Inspector
Dete Reatl
I5'licensed contractor ? owner hereby request inspection of ab.ove ectrical wo
Job AO re s SI et. B or Route ) Ciry
Section No. Township Name or No. R nge No. Co ?
Occupa t(PRIN ) ? ? n Ph e No
^?
.?
_ l/ /1
ivci
Power Supplie Atltlress
T¢al Comra r ?COmpan e? Co rB r's License No,
ccou
ilmg Atlde onhdctor O"r Mdking M f
AutM1 e0 i naWre n ac?ori nerM ing s Ilatonl on
MINNESOTA STATE BOAND OF EIECTqICITV THIS INSPECTION REOUEST WILL NOT
Griggs-MlEway BIAg. - Room S-173 BE ACCEPTED BV THE STATE BOARD
1821 Univerelly Ave., St Paul. MN 55104 UNLESS PqOPER INSPECTION FEE IS
Vhane (612) 662-0800 ENCLOSEO.
REQUEST FOR EIECTRICAL INSPECTION ee^-00001-0e
??? ? See Insimnions for complefing Ihis lorm on beck of yellow copy
?'?'?
W0 2 60
' "X'JBelow Work Covered by This Request
Nlm d R,ap. TypeolBuilding ApplianceSWiretl EquipmentWiretl
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building ryer LOad ManagemeM
Comm.llndustrial Furnace Other (Specity)
Farm Air Conditioner
OInertsyacilyj - ConVaclor5 Remerks'
Compute Inspection Fee Below.
# Other Fee 8 ServiceEntrenceSize Fee # CircuBSiFeetlers Fee
Swimming Pool 0 to 200 Amps , to 100 Amps
Transtormers Above 200 _ Amps Above 100 _ Amps
SignS lnspector's Use Onry. ' TQ??,,-/
Irrigation Booms /? ?' I ` W)
"
Special Inspection TT??
Alarm/COmmunication THIS INSTALLATION MAY BE ORDEREDfDISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 7 ON
I, the Electrical Inspector, hereby
tif
th
h
i Rough-in 1 Dete ?/ ?
cer
y
at t
e above
nspection has
been made. Final '
7 Dete
(p
OFFICE USE JNLY
Th5 lEqu@st v0itl 18 mOnthS flOm
I ,N
IS ?:<?q -:s
L
Naw Const/uction Reauirements
• 3 registered sde surveys showirg sq. ft. of IM, sq. ft. of Iwuse; and pll roofed areas
(20% mazimum lol coverage allowed)
• 2 wples af plan shawing 6eam & window sizes; poured found design, elc.)
• 1 set of Energy Calculatiore
• 3 copies of Tree Preservation Plan'rf lot platted aRer 711193
. Rim Joisl Defail OpGons selection aheel (bidgs with 3 or less units)
DATE ZO 0 L
?.? c)
--?? )"Vl,l•`1.?'?q
RemadaUReoair ReauiremeMs
• 2 copies of plan -? - "?
. 1 set of Energy Calcula6ons for heated adtlitmns
• 1 site survey tar exterior additions & decks
. Indicate if home served by septic syslem for additions
VALUATION
SITE ADDRESS 14-1? 3 04,D MULTI-FAMILY BLDG _Y KN
TYPE OF WORK b r= C-K FIREPLACE(S) _ 0 xl _ 2
APPLICANT
STREET ADDRESS 14-6 3&ri? ?*V?? CITY_ .r? STATE?[IP .('j'?/ 2- i
TELEPHONE # 7 3?? ' 6G1` CELL PHONE # flf? '2¢d ?.?'??F FAX #
PROPERTYOWNER h)Z LFI?6D WOA?h TELEPHONE# ??3?5?/?'66t9
-----------------------------------------------------------------------------------------------
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RUI.H:S 7670 CATEGORY 1 n
(4 submission type) . Residential Ventilation Category 1 Worksheet Submitted •
• Energy Envelope Calculations Submitted
Plumbing Contractor:
Plumbing system includes:
Mechanical Contractor:
Mechanical system uicludcs:
Sewer/Water Contractor:
Phone #
Phone #
JUI. 2 5 2002
5;D
Fee: $70.00
----°-----------------------------------------°°°°-----------------------°--°--------------------------------------
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordin?,rnces,f
Signature af Applicanf
OFFICE USE ONLY
RESIDENTIAL
BUILDINC PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
Waler Softener
Water Heater
_ No. of Badis
_ Phone #
Lawn Sprinkler
No. of R.I. Baths
_ Air Conditioning
Heat Recovery System
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4l02
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 AcceSsd?y BIdg
? 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
? 04 02-plex ? 10 08-plex 0 18 Deck ? 23 Porch (screened) ? 36 Mul6
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
? 31 New ? 35 Int Impmvement ? 38 Demolish (Interior) ? 44 Siding
'0 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 WindowslDOOrs
? 34 Replacement 'Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation 2? ?06)
^ Occupancy 1-1:3 MC/ES System
L
"
Census Code
3 Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
?
V N
T
f
ype o
Const Width
REQUIRED INSPECTIONS
Footings (new bldg) _ FinaUC.O.
? Footings (deck) ? FinaUNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Framing _ Siding Stucco Stone
_ Fueplace _ R.I. _ Air Test _ Final Windows (new/replacement)
_ Insulation _
_ Retaining Wall
Approved By Building Inspector
Base Fee
Surcharge
Plan Review
MCIES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
-1)•2C$-
1' r-'`
SURVEYOR'S CERTIFICATE
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PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMTTS ARE REQUIItED FOR EACH UNTT.
NO. FIXTURES EACH TOTAL
d? SHOWER 3.00 3.00
WATER CLOSET 3.00 `I_oa____._.
BATH TUB 3.00 G.oo
? LAVATORY 3.00 1 P-•no
KITCHEN SINK 3.00 3..00
L LAUNDRY TRAY 3.00 1.00
_ HOT TUB/SPA 3.00
t WATER HEATER 3.00 T,:o "
? FI,OOR DRAIN 3.00 3.0a
? GAS PIPING OLJTLET • miNmum - i 3.00 3. uo
ROUGH OPENINGS 1.50 9.00
? WATER SOFTENER 5.00 S '2oo
PRIVATE DISP. • neiLcty. uc. 15.00
U.G. SPRINKLER • nom unaer oonsL 3.00
ALTERATIONS • to adstiog 15.00
WATER TURN AROUND 15.00
STATE SURCHARGE
SIT'E
UWN
.50
SIGNATURE OF PERMITTEE
PLUMBING PERbIIT (RESIDENTIAL) '
CITY OF EAGAN
3830 PIIAT KNOB RD
EAGAN MN 55122
(612) 6814675
TOTAL: " r. o
CITY: ?o.?/ STATE: ZIP CODE: ??
PHONE #: (?/? )
PLUMBING PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 6814675
PLEASE COMPLETE FOR ALL COMvIERCIAL,/INDUSTRIAL BUII.DINGS. ALSO FOR MULTI-
FAMII,Y BUII.DINGS WHEN SEPARATE PERMTTS ARE NOT REQUIItED FOR EACH
DWELLING UNTT.
_ NEW CONSTRUCTION
ADD ON
T REPAIR
WORK DESCRIPIZON:
CONTRACT PRICE:
FEE: 13'a OF CONTRACT FEE,
STATE SURCHARGE: $.50 FOR EACH $1,000 OF ?!,#c FEE
<.e..?:.?:,.?,.>
hIINdMUM FEE: $ 25.00
CONTRACT PRICE X 1%
STATESURCHARGE
TOTAL
S1TE ADDRESS:
?
$
TEA?4wrr uaILME• a? +t.
v l u. r.
OWNER NAME:
INSTALLER:
ADDRESS:
CITY:
PHONE #:
STATE:
ZIP CODE:
FOR:
CITY OF EAGAN APPLICANT
it// o?1&
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMTTS ARE REQUIItED FOR EACH UNIT.
? NEW CONSTRUCTION
ADD-ON A/C
ADD-0:7 F`JRPdAt:E
FIREPLACE II3SERT
DATE
HVAC: 0-100 M BTU
ADDITIONAL 50 M BTU
GAS OiJ17 ETS (MINIMUM 1@$3.00 EACH)
ADD-ON/REMODEL (EXIS'1'IIdG CoNSTRUCi'ION)
3TATE SURCHARGE
TOTAL
FEES
$ 24.00
6.00
$ 20.00
SITE
OWNER NAME:?TELEPHONE #: \a%1K
TELEPHONE #:
TURE OF PERMITTEE
1994 MECHANICAL PERMIT (RESIDENI7AL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 6814675
CTI'Y: STAT'E: ZIP CODE:
i ?
PLEASE COMPLETE FOR ALL COMMERCIALJINDUSTRIAL BUII_DINGS. ALSO COMPLETE
FOR APARTMENT BUILDINGS OR OTHER MULTI-FAMILY BUILDINGS WHEN SEPARATE
PERMTI'S ARE NOT REQUIRED FOR EACH DWELLING UNTT.
DATE:
NEW BUII..DING
INTERIOR IMPROVEMENT
WORK DESCRIPTION:
CONTRACT PRICE:
FEES
??;;4? FEE
1% OF : ? S.:a<.ra:.:..rtx.::;::.aA.z:
PROCESSED PIPING:
MINIMUM FEE:
STATE SURCHARGE
TOTAL
$
$25.00
$25.00
$.50 FOR EACH $1,000 OF PW44LI FEE.
$
STI'E ADDRESS:
OWNER NAME: TELEPHONE #:
TENANT NAME: (IMPROVEMFNis oNL1) MI " A "
1.9 ? ,?`s?
INSTALI.ER: AftA&Pc ?
ADDRESS:
CITY:
STATE: ZIP CODE:
TRT.FPHONE #:
SIGNATURE OF PERMITT'EE CITY INSPECfOR
1994 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 681-4675
ITY OF EAGAN
830 Pilot Knob Road
gan, Minnesota 55123
(612) 681-4675
PERMIT L)R 19 5?,R-(f
PERMITTYPE: euzLotNG
Permit Number. 022821
Date Issued: 0 2/ 2 2 /9 q
SITE ADDRESS:
1463 PONO WYNDE N
I.OT: 8 BLOCKa 3
DEERWOOD pONbS
P.I.N.: 10-19975-080-03
DESCRIPTION:
:ermit Type
V 'f1d3rIg',P
aldirtg W&rk Type
t?UBC Ocaupan?y??.,
l ?ConsLruetzqn 7y0,?
. ZOtYlng
euitdiervg, Length ? Suildtng Width
, ?uild''xn?j -storzes '
r
/t
5F DWG
NEW
ft-3 M-1
V--N
PO
69
34
2
-Z"L
D?? ?3 (2 c?1
REMARKS:
S& W PLBR - STAR PLBG
FEE SUMMARY:
8ase Fee
PJ.an Review
Surchargs
SPoC
SAC o
SAC Units
Lic. Search Fae
Subtotal
VRLUATION
$947.50
$615.88
$94.00
$800.00
109
1.
$5A00
. $2,46?.38
$188,000
MISC.ELLANEOUS ,828.50
'iotal Fee $4,290.88
CONTRACTOR: - upplicant - sr. Lzc. OWNER:
JUIIK & ASSOCTA'fE5 16887210 0009399 ULIK & ASSOCTATES
1433 DEERW00D PA7H 1433 C7EERWOOD PATH
[AGAN Mld 55122 ERGAN MN 65122
(612) 688-7210 (612)688-7210
I rieraby aeknnwled9e that I have rsacS this applicatian aFlet:staCe tYrat tfie,
infortriaCivn as correct and agr°e to nomply wFtM aJ.I applie:atrle State afi hfn.
SCatutO:s and Gity o-F Eagan Ordinances.
L . ?
A4fa0 ARA ? 171d
APPLICANTlPERM SIGNATURE ISS?ED B SIG ATURE'fl?
-
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
(672) 681-4675
SITE ADDRESS: Lo-r : s B L 0 C K: 3 APPLICANT:
1463 POND WYNDE N JULTK & ASSOCIATES
UEERWOOD PONDS (612) 68E3-7210
PERMIT SUBTYPE:
sF owc
TYPE OF WORK:
NEW
auzLorNc
0?2821
02/22/94
INSPECTION
FOOTINGS DA .
FOUNDA'iION DA
FRAMING ROQFT.NG
IN5ULA7ION FI'REPLACE
ROUGH IN PLB(i ROUGH IN HTG
t=YNAL PLBG F1NAL
REMRRKS: S& W pLBR - 5TAR PLBG
?
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REACTIYATE -.. _.__.... CITY OF EAGAN
oErt14 :#' ._ yg?g-BUILDING PERMIT APPLICATION $+?s ?.qO. ??
? DrC 0 S 9993 'q`? 681-4675
?
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-- 9. ,
----------- -- ,
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specificatvons, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month.
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date llcncmhe/rA_ /1 QO3 Valuation of work $191,000
SitE AddrE55: 1463 Pond Wvnde N
STREET SU1TE N
Tenant Name: (commercial only)
LOT A_ BLOCR 72_ SUSD. Deerwood Ponds T I.D. o
Destri tion of work: New sin le famil residence
The appl i cant i s: ? Owner ID Contractor ? Other (Deccrihe)
Name Juiix & Adler Phone 688-7209
Property LASi FIRST
Owner
address
STREET STE M
City ' State Zip
Company Julik-a-A41cr amawde,F Phone688-320S 7210
COntrBCtaf ,;{{, mobile 868-1864
Address nAve-)4"?????rtuz??c`ense #
Exp.?
?on g?p
City -Rdg-n a4=- & nn 5tate MN Zip -553-t1-
122
Company Phone
ArchitecU
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber . Processing time for
sewer & water permits is two days once area as 6een approved.
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.
Signature of Applicant: ?
i
OFFICE USE ONLY
, -,
t
BUIL DING PERMIT TYPE '?"1
,?
? Oi Foundation ? 06 Ouplex 0 11 Apt./Lodging L? YB`. ?a"''§emN*.&ftsh
J4^02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. ? 17 Swim Pool
O 03 SF Additian ? 08 8-Plex ? 13 Garage/Accessory ? 18 Comm./Ind.
? 04 SF Porch ? 09 12-Plex ? 14 Fireplace ? 19 Comm./Ind. Misc.
? 05 SF Misc. ? 10 Multi. Add'1. ? 15 Deck ? 20 Public Facility
? 21 Misce7laneous
WORK TYPE
M 31 New ? 33 Alteratians ? 35 Tenant Finish [3 37 Demolish
? 32 Addition ? 34 Repair ? 36 Move
GENERAL INFORMATION
Const. (Actual) V41 Basement sq. ft. 444, MWCC System ?
(Allowable)
UBC O V lst F1. sq. ft.
2nd F1
s
ft si?
?2L City Water
PRY Required
ccupancy - / .
q.
. f
Zoning Sq. Ft. total Booster Pump
# of Stories
Z
Footprint Sq. ft. I
Fire Sprinkler
Length C, ? On-site well Census Code /? /
Depth 3 y,3;z On-site sewage SAC Code
APPROVALS
Planning Building Assessments
Engineering Variance
REGIUIRED INSPECTIONS
O Site
? Wailboard
? Footing
? final
0 Framing
? Draintile
O Insulation
0 fireplace
Permit Fee ww.c;on: 000
Surcharge
Plan Review 43sA-?? rs ?-
??3?
? 13?0
License
MWCC SAC
Ci
SAC
Zz.r/?
I 2Z
ty .X
?`
Water Conn.
water Meter --?
Acct. Deposit ?
S/W Permit
S/W Surcharge a
Treatment P1.
Road Unit
Park Ded. 2,Q
Trails Ded. ?-
Copies yoXsy ? r3?o
Other
Total :
( 3 ;
GYo /)_5
SAC %
SAC Units
12/14i93 07:04
SURVEYOR'$ CERTIFICqTE
JUIIK
EA
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R?E. Y 1? W E 0
?
I xm[t BNLOIIp MMEH]101C?pfMIMN ug EAGAN FIVGIIVLfER??VG ?E ,
?o?0arn?ra r '
ypE p?' ? a NDI L• ? ry?p+
0 FGRO?t10N 6PEbPIC 87118 ?Nypg718qTI0N HAB rpgg? ? I
AN6HnlQWt ?L4t4 TMIS LOT BY JAME9 R.
OIMENSIO?S." mu„ ina e ywtae? rr?o ?
40ILS lp 9UppOpT y? g?gCIFIC HOU36 PflOPRyep IB
r D@NOTE$ PROPOSEp BURFqCE UHA1Nq6E NOT iNE AFg{qMIBILI tY pp J4ME6 q.H1LL, IpCr
* bBJ07561[iON MONUMEN7' SCf
XD00.0 TES E DENO7?' E.`tlOSlIN? ELF4A'fI?OM l1Nb SCALE: I INCN - 90 FEET ,
PRUPOSEO OAAA6E ROOR - 84117 FFET
(000.0) DENOTES PflOPO$@p ELEVA710N PROPUBED LO,WE9T FLOOR
Pko?oa .
?0 1C,PoF e?.ocK- gq9, g FEEr ?
WENEREBYCFppFY7p JULIK a qDLEg ' RF'AC9EN7ATION OK A SUqyEyOr n{E gOVNDAplFS OF: TMAT 774IS IS ?j TRUE ANO CX}RRECT +
Lof.g. Aincka. 6lEgnwooo PoNoe
[herlof, bpkotu CoumY. Mh1ryo7010. ?orqln0 io;lho rectrdcd p(pl F
IT ppES NOT PURPOqt . . ,.
3URVE 70 eHOW IMrnOVtmEM6 Oq ENCROACI?'MENTy, LXCFPT
YED 8Y ME OR UNUER MY DIREC7 1gry.? 1?.
SUPERVISION Ti{fS DAYOF NOL; A3 RHOWN. A6 I
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DROrW11D unnoBD lxwMlNdN[ TqKFN 816NFD: JAMESRR?,WWLL LIN?` I
PRGe 1N6' ORANxe 9 6yyELOPIdEN7
RPUI/?S Ap?qy'0lD !T MeCOMB9.FHANK ?` ? I lk` '_^^ I
990CIATEI, INC.
BY ?? ??y
-??•wc qUNBEq 70941
)arnes F:. h?ill, inc. ?
PLANNERS / EPMINPI..-iS / SURVEYORS ?
2500 W. p7y, NU. d9 i BpR?iLLF„ MN. 55337
. 814-8Bo-60?? I
002
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??1'612 890 6244 12-14-93 07:07PM P002 #25
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12i14i93 67:04
SURVEYOR'8 CERTIFICATE
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?si.§ joll?, lames R.Hill, inc.
PUINNERS / ENGINEERS J SUqVEYORs
2600 W. C7Y, RD. 42 8 BW5d8NLLE, MN, bsa97 • 972-00-6014
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1 612 990 6244 12-14-93 07:07PM P003 #25
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0 D 0
Cl? 0 D
12`0 13
a'13 D
D1?0 0
13
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LOT BIIR9EY CBECxI.IBT FOR
SIIILDING BERMIT
? 3-!N 4 4
Dat• of 8urveys
• Reqistered Land Surveycr siqnature and company
• Buildinq Permit Applicant '
• Legal description
• Address
• North arrow and -
• House type (rambler, walkout, split w/o, split entry,
lookout, etc.)
• Directional drainage arrows with slope/qradient
• Proposed/existinq sewer and water services
• Street name
• Driveway
ELEVATZONS
D tr-?0 • Existina
Sewer eervice
13' 0 0 • Lot corners
8' Ll 0 • Top of curb at the driveway
D II" 0 • Elevations of any existing adjacent homes
4roDOged
13 0 • Garage floor
?El ? • First floor
13? 0 0 • Lowest exposed elevation (walkout/window)
tf 0 0 • Property corners
0-13 D • Fzont and rear of home at the foundation
PONDING AREAS H f arelicable)
H? D 0 • Easement line
13 0 - Z? 0 0 , xwL
HWL
H? D?? • Pond # desiqnation
D L3' O • Emerqency Overflow Elevation
,6'13 0
?D D
13 D
D"0 0
Q? 0 0
D ?
October 29
DIMEN8ION6
t.
• Lot lines
• Right-of-way and street width (to back of curb)
• Proposed home dimen$ions includfng any proposed decks,
overhangs greater than 21, porches, etc. (i.e. all
structures requiring permanent footings)
• Show all easements of secord and any City utilities with3n
those easements
• Setbacks of proposed structure and setback of adjacent
?
I
ERTERIOR ENVELOPE AVERAGE "U° COMPOTATSON
(To be submitted with building permit application) 1
One or two family dwellinq ? OwnerWDtJ(, Jpi3
Al1 other
Site Address
Contractor ? ??,??? ?- ???? `•o?g r Date IYIZZ,123 Phone
LINEAL FT. OF -
EXPOSED WALL + + + + + +
+ + above grade =
TOTAL EXPOSED WALL AREA
OPAQUE WALL CONSTRUCTION: "U" value x area
" Ul. x sq. ft. _ (U) (A)
',ull x sq. ft. _ (U) (A)
netail reference "o"=.x sq. ft. 3Ig,W = 3y98 (U) (A)
from - p ??Ul1 ,p47 x sq. ft. Z312.YSS = lUg.`9 (U) (A)
attached sheets "U" ,Qyy x sq. ft. 3d6•4fJ = 19,l1/ (U) ('?)
(3Ln Lx
? t t "0'l sq. ft. ZZI.B? = 31,07. (U) (A)
" _
"U" x sq. ft. _ (U) (A)
WINDOWS: "U" value x area
Make & type "U" x sq. ft. _ (U) (A)
x sq. ft. ?31•t9 = 1%4,08' (o) (A)
uU _x
,y? sq. ft. $d.00 = .3(? VO (U) (A)
.lUll _
_
x sq. ft. _ (II) (F+)
DOORS: "U" value x area
Make & type x sq. ft. _ (U) (A)
U" .07 x sq. ft. 37?9 = SGU (o) (A)
„U" x sq. ft. _ (U) (A)
TU TAL5 30 967 $2 sq. tt. +{ / 7, 43 (U) (A)
TOTAL (U)(A) VALUES 417??{j °
VG U"
"
DIVIDED BY TOTAL WALL AREA gOti, SL ?? ! .
A
.?, Avg_ "U" value, Sta te Code
ROOF/CEILING:
TOTAL AREA: 1S8'V(J sq. ft.
Detail reference x sq. ft. _ (U) (A)
from "o" p .x sq. ft. I y?2S0 = 3l,23- (U) (A)
attached sheets. RjSSCa(%,) A4/1 ??U" ,0q x sq. ft. Q4,yZJ = 31719 (U) (A)
Describe openings "U" x sq, ft. _ (U) (A)
in roof "0" x sq. ft. _ (U) (A)
TOTALS fSd70L S4• ft• 35;03 (U (A)
TOTAL (U) (A) VALUES
VG ?? ??
U
DIVIDED BY TOTAL ROOF/ 1 y"g7 ,dtl ?OZ L A .
CEILING AREA , .Q"Avg. "U" Value, State Code, Veqted
.10 Avg. "U" Value, Sta te Code, Unvented
MINNESOTA ENERGY CODE MAXIMUM THIS BUILDING ESTIMATED
BTU LOSS THIS BUILDING BTU LOSS .
71$L SQ. FT. OPAQUE WALL @? _ ?I$g? ?I??i?I?J Ir87,QQ 5Q. FT. CEILING @oZG= q I # Z.L 3? • U'? ?
SQ. FT. UNVENT CLG. @.lU = i'OTAL BTU TASSIHR./SQ. FT./ 1.
DEGREE OE TEMP DIFFERENTIAL = T 6 U• ? z uLS 2 ?4 (o I '
lin. £t.
WALL SECTION5
NOTE: Use 10$ of opaque wall area for
frame construction
---?
1= '?
- ?
AASIC -? -_.-45)
IFALL . ?
"Un . 1
A
Construction
1. Interior air film
'
2.
3, ? inches soft w?
4.
5. tp iu(
6. Exterior sir film
1 _ j I --U??
q,oa ' L.
FIG. #1 TOPYrIEV'1 OF
FRAto15 VfALL
FIG. # 2
ii
Peripheral
Floor 'Vsll
FO i7IJDAT I ON
?^IAI,L i
o'0 :10.
o;
. O . o'.
' n . . ?.
. .O .. ?.
• a
? n o ° n
.t
.0
6?QL
V GL
, O
/
; . ?. n .
FIG. # j
.o , . . . b
o . . o . ...
0
' .
1.
2.
3.
4.
5.
6.
0.68
0.17
? 1 1
? O.,
U=
-?iZ _
_
-
11.?2.
? 1. Interior air film. 0.68 0.68
? 2. " .(n. uL. Oa
3 db I?zs ,
SoerwJeah ' ?, &8
?
--.? .
a. ?
-T ' os i3 L t
? s. ? ?? N?,
--? 6. Exterior air film 0.17 0.17
Total ?
6
o? y4 'lu" ° 1 -
?
O 1. Interior air film 0.68 0.68
2.
fl s.
?j 4-
5.
? 6. Exterior air film 0.17 0.17
Total ?,33
'lu,l = 1 = Jy ?, = 1 -
?.33
SLAB ON GRADE
I I I I?I
? ' . . . . . a: ?
:-? • J
- ? - . . .. . .i
' ?
. ' ' o •
. ..
o
? . . • . • ? ,
- c ? . ..
a . ? , . .
• , ? J
. ?. ? . .
p
? _. ?? I ' ' . .. • .
NOTE: Indicate type, "R" value, depth and
placement of insulation. , • `
2
R-Value R-Value
0.68 0.68
.4S
0.17 0.17
,DD
ROOF/CEILING
VF:NT
Vented
FIG. # 15
FIG. # :
3
Construction R-Value R-Value
1. Interior air film 0.61 0.61
2.
?
3. f?Lmjjjjj Ueoi.
o
N44p
4. Exterior air film (still) 0.61 0.61
'POtal 45: 9d
uUn = 1 0
0= 46.78 ie
1. Interior air film 0.61 0.61 '
z. ? n. s
3. Cord Depth 3 A " L !ry '-h38
n. 1900
5. Exterior air film (still) 0.61 0.61
Total 2S?lL
1 1
.lull _ = r0 glue.
zs?iL
1. Znterior air film 0.61 0.61
2.
3.
4. Exterior air film (still) 0.61 0.61
TOtdl
1 1
uU?? ? v °Un
I
../ 3?
? NON VF.MTFD
Eenti ?
Flow Up
FIG. # 8
I -..
1. Inside air film 0.61 0.61
2.
3.
4.
5. Outside air Pilm 0.17 0_17
Total
1 1
„Ull _ = .. U.. _ =
NOTE: Use additional sheets if more space is ,
needed for details and calculations. .
/ \ Heat Flow Up
?4 ?
I 1 Heat Flow Vp Yanted
?---?
FIG. #' 7
.
..Window Areas, Door Lite Insulated Glass Area, .
Special InsuYated Glass Azeas
NOTE: Unit Quantity=Nwnber of units in group Sq1=1, mu11=2, etc.
QTY DESCRIPTION UNIT QTY SQ FT/UNIT TOTAL SQ FT
J ' nU
? ZO/i0 -1 ? li' i4?a1F?RwNSO??a?3wt ? _ 3 l?G 3?.92
? C zo?? -z. Z. ' a 1 v.aa
c z43 `7-1 ? G,ou ?oa
L Oo
? ?,UlJ
_ CzaYB'^ aJ LAj a v . 3•?f 2V,a3
? G v s" i' , ??C _ ?_ 2h•Sv -.5sa 3;,o u
? a w ?• << r +. 30?4 ? _ zs?vv-?s:oo 3a,ua
? 4fS4U 13-34 13.3v
?- I?31.yU . I Id•Ud /d.0u
TOTAL WINDOW SQUARE FEET I(7g, Z,i
"U" Rated @
Entry mors
mors With Znsulated Glass Figure Gl ass Area with Windows
Entry Units With Side Lites List Side Lite Only Separately-nouble Door Equals 2 x Single
QTY DESCRSPTION
? l°r u? • Sr4c L -?
2??Srss. c I a?-
UNIT QTY SQ,FT/UNIT TOTAL SQ FT
TOTAL DOOR SQUARE FEET
Door "U" Rating ••u4
Side Lites
QTY DESCRIYTION SQ FT/UNIT TOTAL SQ FT
? tl
o' /., DU 12v6
7a.,aaOse,,., _ s.DV 5 u o
? ?,(?? L0 u L?o v side Lite "U"
Rated
TOTAL SQUARE FEET F-3. yo I
Patio Doors ? .
QTY ?DESCRIPTION UNIT QTY SQ FT/UNIT- TOTAL SQ FT ,
I 2 Vvt/ _Pariu 1)7L. ?_ Zd.ae ' S'd.0u
"U" Rated ? TOTAL PATIO DOOR SQIIARE FEET
? .._..._-------- "_._..------ -- -----._. ..._..___..,_.
t
WALL AND CEILING AREA COMPUTATIONS
7b Figure StudWall Area
5
Standard stud wall incl, plate= fo)el sq. ft./lin. ft. x/?y' lin. ft. wa11=rSL9,4sq, ft. wall
Knee stud wall incl. plates= o,?$$ sq. ft./lin. ft. x 1 P'7 lin, ft. wa11= $Z;9(,.:sq. ft. wall
Other stud wall incl, plat.es= 9,0 sq. ft./lin, ft. x/(oo$, lin. ft. wa11=15t7,12.,sq. ft. wall
Other stud wall incl. plates= sq. ft./lin. ft. x lin. ft. wal1= sq. ft. wall
TOTAL .3I ?q•.Sc/
Stud And Plate Area
Total sq. ft. stud wall area including knee wall area =311,$ sq. ft.
10% total stud wall area3f ,1 = 3116 sq. ft. stud and plate. This percent allowed by state.
Rim Joist
Lin. ft. rim joist 3z.Z, xsq. ft./lin. ft, rim joist = 384,yo sq. ft. rim joist
Lin. ft, rim joist x sq, ft./lin. ft. rim joist = sq. ft. rim jofst
Lin, ft, rim joist x sq. ft./lin. ft. rim joist = sq. ft. rim joist -
Exposed Basement Block
Inches above qrade ? x.0833 x/&y lin, ft. wall = s4. ft. block
Inches above grade x.0833 x lin. ft. wall = sq. ft. block
Inches above grade x.0833 x lin. ft. wall = sq, ft, block
Inches above grade x.0833 x lin. ft. wall = sq, ft. block
2nches above grade x.,0833 x lin. ft. wall = sq. ft. block
Inches above qrade x.0833 x lin. ft. wall = sq. ft. block
Inches above grade x.0833 x lin. ft. wall = sq. fk, block
[vet wall Areas juraL• 22-1lSS
Total stud wall area .1119alf' &asement block area ZLliB?
Less windows 431,zy% Plus area well
Less doors 31,11 r.ess windows
Less patio doors tD•OU Less doors
i.ess stud and plate 314.00 Less fireplace
Less firepl.ace TOTAL BASEMENT BLOCK AREA
TOTAL Z, 312? H8'
Ceiling Joist or Cord ,
Number of cords or joists 3 x 'Z t' length = G4.00 total lin, ft. x.125 sq, ft.
Number of cords or joists Z x Iy 'length = ZX,pU total lin, ft. x.125 = • sq, ft.
Number of cords or joists x 3y. length =(014.00 total lin. ft. x.125 = ,sq. ft.
?1 U•°" TvrAt: 7{G•00A '125_ 44.s"o
Ceiling Area
Ceiling width x ceiling length = sq. ft. ceiling 71587.a o
Ceiling width x ceiling length = sq. ft. ceiling
Sq. ft. ceiling 1?g7,p? less sq. ft. cord 9Q.,sa: ° l?lqy•Sb sq• ft. insulated ceiling
Sq, ft. ceiling less sq, ft. cord = sq. £t. insulated ceiling
FIREPLACE
Opening width x openinq height =
sq, ft, fireplace'
iry'l?Cp A
?U?pW?J?u?ryN '
i
- city of eagan
MEMO
TO: DIANE DOWNS, UTILITY BILLING CLERK
FROM: ED KIRSCHT, SR. ENGINEERING TECHNICIAN
DATE: AUGUST 26, 1993
SUBJECT: STREETLIGHT ENERGY COSTS - DEERWOOD PONDS (28 LOTS)
This memo is to inform your department to begin to invoice the energy costs at the single
family rate effective August 1, 1993 to the property owners in the Deervvood Ponds
Addition.
The City is currently being billed by Dakota Electric for streetlighting in the above listed
subdivision.
c??-?:; ?.?.k
?
Edward J. Kirscht
Sr. Engineering Technician
cc: Michael Foertsch
EJK/je
L 0 b
SUBD
?
NEW RECEIPT If q?,Ip,S(p
RECEIPT DATE 6e/Z?9 _
T'0
V
JOB
OWN
l?
I1ATE V J 7-
PS.RASE 9E .":Dyycc+n TueT TtfL'aE Tc I Fcw' S}?OP.TAGMr' QN T}tL` lAl1VG'
II.ECTRICAL IISTALLATION IN THE ANOUHT OF $ 30 ' w
SNORTAGE MUST BE PAID WHITHIN 14 I1AY5.
R EMA R f6
f?O 0 to 30 amp. circuits= ?;/v
31 to 100 amp. circuits= 7
0 to 100 amo service=
I .re,
_ TOTA . FF. . HORTA . DUE _ `P 30 •
Pe?uMir#lf/G,;7/?'G O
OBIG. RECEIPTl1- p 7 -.?
RECEIPT DATE q-CG-Te
1?
RETUHN A COPY OF THIS FOBM WI'IH REMITTANCE.
E3r.
LESS F£E RECIEVED /(10,7140 , _7 2, leci
m?z)
0?
2007 RESIDENTIAL BLTILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New ConsWCtion Reauiremenis
3 regislered site surveys showing sq. ft M Id, sq. ft. of house; and all roofed areas
(20%maximum lot coverage allaxeC)
1 Soils Report H propwed building is N be placed on tlisWrbed soil
2 copies of plan shaving beam 8 window sizes; poured found design, etc.
1 set of Energy Calalations
3 capies of Tree Praservafion Plan if lot plafled after 711193
RimJdstDetailOptionssdecfionshaet (buildingswAh3wlessunils)
Minneqasco mechaniral ventllation form
gv, OD
RemodeVReoair Reaulrements Office Use OnN
2copiesotplanshowingfootings,6eams,jois4s CeRMSurve¢Recd _Y _N
t sat of Enerqy Calculatlons fa heated additions Sals Repat _ Y_ N
t sile survey for addi0ons & dedcs Tree PresPlanRecd _ Y_ N
Add'6'on-indicatelfon-sfteseptksystem .
Tree-PresRequved _Y_N
Onrsde5eptic5ystem _Y _N
rians are cvnsiaereo
Ulll@SS VOU SLaLQ tIIBV 81'e LI'8tle 58C1'@t 8ftd th@
Date Construction Cost / - `"-
-?
SiteAddress ?b) ya,o ? UniUSte #
Description oF Work
Multi-Family Bldg _ Y )(, N
Property Owner
Contractor
Address
Y
Fireplace(s) _ 0 _ 1 _ 2
?i1FfF? CL`??r?r
LAKEWOODS REMODELING, INC.
9001 E. Bloomington Freeway
? Sui[e 144 !
' Bfoomin ton MN 55420
? City
State
.__..?.. - ....,? Telephooeti(?.J3)???-?S?d
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Energy Code Category - Minnesota Rules 7670 Cateeorv I _ Minnesota Rules 7672
. Residential Ventilalion Calegory 1 Worksheel . New Energy Code Worksheet
submission type) Submitled Submitled
. Energy Envelope Calculations Submitted .
In the last 12 months, has fhe City of Eagan issued a permit for a similar plan based on a master plan2
_ Y _ N If yes, date and address of master plan:
Licensed Plumber Telephone #( )
Mechanical Coniractor Telephone #( )
Sewer/WaterContractor Telephone #( )
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accu
mat the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval ofplans.
Telephone # (
-fE"1?1 YcS;tl / / /[Y I // /I
Applicarit's Printed Name Applicant's Signature ?
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA109636
Date Issued:03/25/2013
Permit Category:ePermit
Site Address: 1463 Pond Wynde N
Lot:8 Block: 3 Addition: Deerwood Ponds
PID:10-19975-03-080
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
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.
Deb Larson
8815 209th St
Lakeville, MN 55044
Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087
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 -
Wafai Wong
1463 Pond Wynde N
Eagan MN 55122
Drain Pro Plumbing
8815 - 209th Street W
Lakeville MN 55044
(952) 469-6999
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA131940
Date Issued:07/15/2015
Permit Category:ePermit
Site Address: 1463 Pond Wynde N
Lot:8 Block: 3 Addition: Deerwood Ponds
PID:10-19975-03-080
Use:
Description:
Sub Type:Siding & Windows/Doors
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of house wrap and leave on site for 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: 8,000.00
Fee Summary:BL - Base Fee $8K $162.25 0801.4085
Surcharge - Based on Valuation $8K $4.00 9001.2195
$166.25 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 -
Wilfred Wong
1463 Pond Wynde N
Eagan MN 55122
Lakewoods Remodeling
9001 E Bloomington Freeway #144
Bloomington MN 55420
(952) 888-5550
Applicant/Permitee: Signature Issued By: Signature