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3979 Pumice Lane cirY oF EA"N • ? 3795 Pilot Knob Road Eagan, MN 55122 N2 4959 PHONE: 454-8100 11514 BUILDING Receipt # PERMIT l. l 00i), ? > <* i?u"" ?° 8 o be u?d f T or 1?a[it :c?o[n ?i Gat?.st. Value Date , 19 Site Address 3979 YumiCe Lri Erect ? Occupancy * Lot B rr. S Alter ? lock h Sec/Sub Zoning 1 1 . 4 Parcel #. Repair ? Fire Zone 3 Enlorge a Type of Const. ? a Nome kichard Thorne Move ? # Stories AddA Z Address . 3979 Ptunice Ln Demolish ? Front 22, 14 ff. o ? Ci 5w ;1' ;?31 4. ' i Grode ? Phone Depth 2-' 2?' ft. "----.._1_ em. w Nome Suaeal Cn. 0 ?? Address 1850 C:Orno AVe. St. Pau'.. 645-0331 Name _ Address I hereby ocknowledge that I have read this application and stote that the information is correct ond agree to comply with oll applicable State of Minnesota Stntutes and City of Eagan Ordinances. Signature of Permittee Assessment _ Water & Sew. Police Fire Eng. Planner Council Bldg. Off. _ APC Permit `*?•vv Surcharge 7.00 Plan check SAC Water Conn. Water Meter Total _52.tio :.ie.hsrd ''ho,'fle `'ussel ?:cr. A Building Permit is issued to: on the express condition thet all work shall be done in accordance with all appliwble State of Minnesoto Statutes and City of Eagan Ordinances. Building Officiol Permit # paM laued Pwmkt" Plumbing Mechanicol INSPECTIONS DATE INSP. Rough-I n Finol Footings ? ol Date Insp. Date Insp. Foundotion Plumbing Frame/ ins. Mechonical Finol '_/7p- ? Remarks: /0_ ;3 ' 2K ( f 12"-/f - 7 r .,-m '4-? CITY OF EAGAN Remarks * Cedar Grove Acquisition Additio Lot 2? Bik 6 Parcel 10 16704 200 06 Owner ? ?-, (: 1 ' I j "' : L Street 3979 Pumice LdA@ State ?? , ? 55122 ' ? Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK L 1967 100.00 5.00 20 Paid SEWERLATERAL 3 1967 603.00 35.1$ 20 Paid WATERMAIN * WATERLATERAL 192 1972 607.00 24.28 25 WATER AREA STORM SEW TRK Z 1974 70.00 4.66 1$ Pd1d STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. 16 3 sac 200.00 452 10-25-67 PARK INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: -;,•. ;; :? Eagan, Minnesota 55122-1897 Date Issued: ?: t,•;:? ; (612) 681-4675 SITE ADDRESS: ° a ? • ?? = 10 L c,T - t ;tttltt'F' 1,A1Vl ?rs: ,s• . . ; PERMIT SUBTYPE: 16704 - , 00 -01 APPLICANT: 20 Bt.OVk , HE3F21 ZOPf R01i F if1ca TYPE OF WORK: OfE 'Ax aa 0 f',KIP"''i'1 4aN lF21)f?1- i"fi,I };rjt?f f hir. F ? L ??? ?,a • ?? ? Permtt No. Permit Nolder Date Telephone # ELECTRIC PLUMBING HVAC Inspection Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FTG DECK FINAL - cirr oF EaGAN ? 3795 Pilot Knob Road Eogon, MN 55122 No 4959 PHONE: 454-8100 BUILDING PERMIT APPLICATION $11,000 Receipt .# 11514 . To be used for Fam Room d. Garg-si• vaiue Date Aug. 30, '19 78_ ? Site Address 3979 Pumice Ln Erect ? Occuponcy Lot _?() - Block fa Sec/Sub. rG-5 . Parcel # w IName Richard, Thorne z Address 3979 Pumi ce Ln o _ agan ?. 4J4-6109 ? Name Si, S.S P t r,rl„ ,O o? Address 1850 Como Ave. f. Ci ?, St. Paul phone 645-0331 Name _ Address Phone I hereby acknowledge that I have read this application and state that the information is correct and ogree to comply with all applicable State of Minnesota Statute nd City `f an Ordinancen i-_n Signature of Permittee Alter ? Zoning D + Repair ? Fire Zone -T Enlarge [a Type of Const. V Move ? # Stories Addn Demolish Q Front 22 14 ff. Grade ? Depth 24. 24 ft. Approvais Fees Assessment Woter & Sew. Police Fire Eng, Planner Councii Bidg. Off. APG Permit 45.00 Surchorge 7.00 Plan check SAC Water Conn. Water Meter Total 52.00 A Building Permit is issued to: Richard Thorne Sussel Ccah the express condition that all work shall be done in accqfdunce w''rtfi ajl pp?J cable State of Minnesoto $tatutes and City of Eagan Ordinances. Building Officicl EAGAN TOWNSHIP BUILDING PERMIT N° 1656 --•-----?--{-?2----- ---- -------:°-`•"=,?..-?? --------- --- Owner ' ---•-- --- ----L ---------- Eagan Township Address (preseni) .??-?-?----??--'A?:•?v`----1?............... - ---- Town Hall Builder ............................. ....---....._..---------•-•--------.- ------------------------- - • Date ...... /..?z_?_" Address ?----------------------- .... ............................................................. --•--••-----•-----•-••------ DESCRIPTION 52ories To Be Used For Fron3 Depth Height Es2. Cos3 Permit Fee Remarks ------ - -.. -- ---T - _- - . ? ---- --- - -- ---- - --- -- - -- -- -- - - ------- -- - LOCATION Sireet, Road or other Descripiion of Loca#ion I Lot B;ock ' Addition or Traci -- ---------- -_----------- -1 3 9 - ?-_??-_?--I -- ---- --- 4? I This permif does not authorize the use of sireets, roads, alleys or sidewalks nor does it give the owner or his agent the right io create any siiuation which is a nuisance o= which presents a hazard io the healfh, safefy, convenience and general welfare to anyone in the community. THIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WORK IS IN PROGRESS. ? This is to certifY• that •°?• :•°-•---•--------.has permissionx to erect a---- ---..?•?• •••-•- lLi4-c.?t? --- ?_..? =_ _.___...._...__. ? ?_'__ . `_ '.. .upon !he above described premise subjeci to the provisions of ihe Building Ordinance for Eagan ?I'ownship adopted' April 11, 1955. ' -" ......................... 3 -' " ,' "'- ........... -?---._. Per ----------•---•••-..._t ---c--??±E.t? ---•--•---? ? ------ Chairm?(n of Tnwn Bo rd ? Buildinq Inspector ? R ?. Minnesota State Board o.f Electricity % 1964 University Ave., St. Paul, Minn. 55104-Phone 645-7703 ' REQUEST FOR ELECTRICAL INSPECTION CijECK BELOW WOItK COVERED BY THIS REQUEST `R 1391 ype of Building New Add. Rep. Check Appliances Wired For Check Equipment Wired For Home ? ? Range ? Temporary Wiring ? lruplex ? ? Water Heater ? Lighting Fixtures ? Apt. Bldg. ? ? ? Dryer ? Electric Heating ? Commercial Bldg. ? ? ? Furnace ? Silo Unloader ? Industrial Bldg. ? ? ? Air Conditioner ? Bulk Milk Tank ? Fazm ? ? ? List ?e ers? _ List rs? Hei ( Other ? ? ? e COMPUTE INSPECTIO N FEE B ELOW ? Service Entrance Size: # Fee Feeders& Subfeedkl ee Circuits: # Fee 0 to 100 Am s. 0 to 30 ' es 0 to 30 Am eres 101 to 200 Amps. 31 to 10 " re 31 to 100 Am eres Above 200 Amps. Above 100 mps. Above 100 Amps. Transformers Remote Contr Circ. Partial or other fee Signs Special Inspection Minimum Remazks TOTAL E/Q, DU I, the Electrical Inspector, hereby certify that the above inspection has been made. (Rough-in) Date (Final) ? ,, _ ^ ? Date ? ? This request void 18 months from `...,?? void 18 months from ,-h(j • 0 / 7 ? ??-? ? 1391 laie of this Request I, as X Licensed Electrical Contractor ? Owner, do hereby request inspection of the above electri- cal wiring installed at: Street Address or Route No. Section Township Which is occupied by_Z Range County Is a roughin inspection required on this job? Power Supplier ... . . / ? Electr i cal Contractor mp ny N. Mailing Address Authorized Signature k- (Ele cal Contractor or O No ? Yes CK Ready Now ? Will Call ,g _Address ? Contractor' License No?d ? or Q n r Making This Installation) Phone No. aking T ils Installation) This inspection request will not be accepted by the State Board unless proper inspection fee is enclosed. ? _. 44t . nA2E BUILDII3G PERMYT APPLICATIOiV Include 2 sets of pl.dns, 1 site plAp-?elvat?ons and 1 set of energy calculations. ? ?. e ? l/ ? To be usecl for ? Valuation Site Addresc Lo 20 t Block ? See. Sub, ? Octimer • Address Contractor ? Address Parcel Numiier b!? Telephone -Vx- *V- q Telephone 4 a S+V 3-3 ? Arch./Eng. Address t Erec V Alter R+epaix Enlarge Nove Ieriolish Grade OFFICE USE Date of Approval & Initiai Assessment water/Sewer Police Fire Enq. Plantler Counci2 Bldg, Off. A.P.C. Telephone OFFICE USE , Occupancy ? ? Znning }"l^ I Fire Zone ? _.,. Type of Const. # of Stories Front PJ.,,A °1" iZ -- Depth E'EES 00 Permit Surcharge "p3an Check SAC e? Water Conn. cJater Meter TOTI3L .?' "ities Digital ? 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. ? . Y a ? ? b . u ?. i ._ . ? _ ? _ ! k .=-.r, •-.. .- . . - . _ ?'R ? ?„?""" ? _ ._ > ?... .. .. . . . . . `? .r ? ?. Y ? . , , r . , j .?. , ? 1k ?'' r Y . + r A ? i . . °-?e_••F_ ?? --t.,a.. ? • -• _ , p' ,?,{ c ? ` ?.'t . ? ' -.r-.. . V j • . "?,?z ? "?.°?_? ?. o.? . ...+... .. . . , - - _ ? , . , _ --?F - --- TH E SUSSE L CO. RESlOE 645-0331 a°°Ri 1850 CQMO AVE., 5T. PAUI., MIfVN. AREA: CB OF: DATE: _ i: . FI.AN Nq. ? . ,. . . i.: 7?` ? .0 -4-_ •k.y.,?;.n.i,•.i? y?,t 1?+ ,.:•i , i •,• ?•i:,?:.s?,.. •.1:?b .U fi .. .?( •a?.. .?,?(.:?•. ..i;,t..r:.. ?j•.i,)?.df ., 'j.?et. . t.•iy: !,a ?4 ry,:, )(::..3+h!`?;?,}',/.j?,?n.r5*.:;•.: CITY ..fi" I::.A(;;AN r•} ..'. ?` ? ? ? r•. ..?.?.....? /• •.i ? i ?.:. t '•9t:, i'.17.`.:;1-?s.l?.l'? ,; ?';?..., . ?.`:11;:?''•r`.::?( ?(?i.?'fi?.;. :I.?I'?iit.i,;.i;.?. ??:.;, .., ? .4 .::C:.':.?..? , ? ...,,_ ?, .?..., ?°1..???A?..::L .. .... : ? .? {."..?..,?. ,..,.? ... 9001 .:!?::?(::? .. ! •.,! dhA C? 5 11 '1_-? ? I.) ?.. a.i .?. i'... ... ... • ?, 1••l?Ilt.; ...f,?.?. .. 1"? ... ..., .:.i•? ?..?.1 A. .. ._ ?.. ...tC: i"? n ? •..? C?t; ? ?}•i A it?'.}k.,;? . j {r-.s...'..? ' 7•? ? ?.l?:??!{"?.r ... ... i? I+...:v ?..7?]}C:.°. ,py.•d.yt.:?,y:•.?.,i:y..i:,?a.,o.u.;.,r,•.?,.t:•.r,.??,?.:?,.o,.?:,?.,?.•?.?. _.!:.;;,,.?.?.a. ,?.u,?::?..:, 4 CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: PERMIT PERMIT TYPE: ? p?IL4? ? ?? Permit Number: Date Issued: 030831 09/23/97 3979 PUMIGE LAidE LOT: 20 BI.QGK: 6 GEDAR GROVE #5 P.I.N.: 10-16704-200-06 DESCRIPTION: (RooFZNG) rmit Type ?°k :?.-TY p e sF (Mssc.) REPRIR 434 ALT. REsxoENTSAL I& ? e-s ? tea$ .???. REMARKS: FEE SUIIAMARY: Base Fee Surcharge Tatal Fee 'v VALUAT'IqN $29.25 .50 $29.75 $800 CONTRACTOR: OWNER: , -- APPlicant - 5T. LIC HORIZON Rqf1FIlUG 18903900 2901279 GUERTLER LINDA 1333 LARC INqUS7RIAL BLVQ 3979 PUMIGE LN BURNSVILLE MN 55337 EAGAN MN 55122 (612) 890-3900 (612)452-2026 APPLICANT(PERMITEE SIGNATURE ?IN14 9ISSUED B: SI A R 1997 BUILDING PERMIT APPLICATION (RESIDENTIAL) CiTY OF EAGAN AMBI 3830 PILOT KNOB RD - 55122 681-4675 ew Construction Reauirements RemodeVRenair ? 3 registered sfte surveys ? 2 copies of plan ? 2 copies of plans (inGude beam & window sizes; poured fid. design; etc.) ? 2 site surveys (exterior additions & dedcs) ? 1 energy calculations ? 1 energy calculations for heated additions ? 3 copies of tree preservation plan 'rf lot platted aRer 7/1/93 required: _ Yes _ No " DATE: 7//9/ 9? CONSTRUCTION COST: DESCRIPTION OF WORK: STREET ADDRESS: -?g 9y X?`u?? " (1-atz-g- ? LOT 10 BLOCK SUBD./P.I.D. PROPERTY Name: L117dQ. Phone #: OWNER VM ?e* / Street Address:?27 9 c)?ic. e LG ,2e.- City: State: Zip: CONTRACTOR Company: Phone #: L!?i ?3 906 Street Address: /a33ZfiA:"C-L'0/, /--YL ci ense #: ? Z? 79Q? City: 60eO-SOille-' State: Zip: 6a3 ARCHITECT/ Company: Phone #: ENGINEER Name: Registration #: S#reet Address:?.,. ? City: State: Zip: Sewer 8 water licer•ned plumber (new construction only): . Penalty applies when address change and lot change are iequested once permit is issued. 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: OFFICE USE ONLY Certificates of Survey Received Yes No Tree Preservation Plan Received Yes No Not Required BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 02 SF Dwelling ? 07 4-plex 0 03 SF Addition a 08 8-plex 0 04 SF Porch ? 09 12-plex a 05 SF Misc. 0 10 = plex WORK TYPE 0 31 New o 33 Alterations ? 32 Addition o 34 Repair GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning ? # of Stories Length Depth APPROVALS OFFICE USE ONLY ? 11 Apt./Lodging ? 0 12 Multi Repair/Rem. ? a 13 Garage/Accessory o ? 14 Fireplace n 0 15 Deck 0 36 Move ? 37 Demolition ? Basement sq. ft. Main level sq. ft. sq. ft. sq. ft. sq. ft. sq. ft. Footprint sq. ft. Planning Building AM s ?. 16 Basement Finish 17 Swim Pool 20 Public Facility 21 Miscellaneous MC/WS System City Water Fire Sprinklered PRV Booster Pump Census Code. SAC Code Census Bldg Census Unit Engineering Variance Permit Fee Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter ? Acct. Deposit S/VN Permit S/VN Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: Valuation: $ % SAC SAC Units ? - city of eagan MEMO TO: DIANE DOWNS, UTILITY BILLING CLERK FROM: ED KIRSCHT, SR. ENGINEERING TECHNICIAN DATE: AUGUST 239 1993 SUBJECT: STREETLIGHT ENERGY COSTS-CEDAR GROVE NO. 5(208 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 Cedar Grove No. 5 Addition. Block 1, Lots 1-22 22 Block 2, Lots 1-19 19 Biock 3, Lots 1-11 11 Block 4, Lots 1-16 16 Block 5, Lots 1-25 25 Block 6, Lots 1-22 22 Block 7, Lots 1-25 25 BIoCk 8, Lots 1-5 5 Block 9, Lots 1-2 2 Block 10, Lots 1-23 23 BIoCk 11, Lots 1-14 14 Block 12, Lots 1-9 9 Block 13, LotS 1-15 15 208 The City is currently being billed by Dakota Electric for streetlighting in the above listed subdivision. Z/1.- 4 ? Edward J. irsc t Sr. Engineering Technician cc: Mike Foertsch EJK/je w EAGAN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 PERMST FOR SEWER SERVICE CONNECTiON DATE:?,? OWNER: ? PLUMBER NUMBLR ? 0 r Address , ,1?c,'D TYPE OF PIPE DESCRIPTION OF BUTLDING Industriall Comnerciall Residential Multiple Dwelling No. of units Location of Connections: Inspected by: Date Remarks: Connection Charge Permit Fee SCreet Repairs Total 7•S° By Chief IrYspecCOr In consi3eration of the issue and delivery to me of the above permit, I hereby agree to do the proposed work ia accordan.^.e with the rules ar.d regulations of Eagan Tawnship, DakoCa County, Minnesota ...__..___.? PleRse ±s,oti,ty when ready for inspection and corneceiox! aa3 before any gort3.on oi icae ur.?rk is cc,vered. , 70 0 U r?l PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. ---------------------------------------------------------------------------------------------------------------------------------------- NEW CONSTRUCTION ADD-ON A/C ? ADD-ON FURNACE FIREPLACE INSERT DATE FEES HVAC: 0-100 M BTU $ 24.00 ADDITIONAL 50 M BTU 6.00 GAS OUTLETS (MINIMUM 1 @ $3.00 EACH) ADD-ON/REMODEL (ExISTING CorrsTRUCriorr) $ 20.00 STATE SURCHARGE TOTAL .50 ? SITE ADDRESS:??????? OWNER NAME:,???v TELEPHONE #:952-??? INSTALLER: I?6 BNA?NEL ROAD • Nt?t? ADDRESS: EUQAN. MN 65122 CITY: STATE: ZIP CODE: TELEPHONE #: .? / SI NATURE OF PERMITTEE 1994 MECHANICAL PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 6814675 1994 MECHANICAL PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 6814675 PLEASE COMPLETE FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS. AISO COMPLETE FOR APARTMENT BUILDINGS OR OTHER MULTI-FAMILY BUILDINGS WHEN SEPARATE ' PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. - ---- - --- ----------------------------------------------------------------------------- DATE: CONTRACT PRICE: $ NEW BUILDING INTERIOR IMPROVEMENT WORK DESCRIPTION: FEES 1 % OF ??;UW FEE $ PROCESSED PIPING: $25.00 MINIMUM FEE: $25.00 STATE SURCHARGE $.50 FOR EACH $1,000 OF ?FEE. TOTAL $ S11 lf-EAi.31.)RESS OWNER NAME: TELEPHONE #: TENANT NAME: (IMPROVEMENT'S ONLI) INSTALLER: ADDRESS: CITY: STATE: ZIP CODE: TELEPHONE #: SIGNATURE OF PERMITTEE CITY INSPECTOR ,-? i City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 3979 Pumice Lane Lot: 20 Block: 6 Addition: Cedar Grove 5th PID:10- 16704 - 200 -06 Use: Description: Sub Type: e- Siding Work Type: Siding Description: House & Garage Census Code: 434 - Zoning: Square Feet: 0 Comments: Fee Summary: Valuation: 3,000.00 Contractor: Window Store LLC 9909 S Shore Dr Suite 270 Plymouth MN 55441 (763) 412 -4280 Permit closed PERMIT City of Eaan BL - Base Fee $3K Surcharge - Based on Valuation $3K Total: Applicant/Permitee: Signature - Applicant - Construction Type: Occupancy: $90.00 Owner: Linda D Gueitler 3979 Pumice Lane Eagan MN 55122 Permit Type: Permit Number: Date Issued: Permit Category: thout required inspection(s). Letter & correction notice sent to applicant on 7/14/09. (pf) When installing ventilated soffit material, remove existing soffit material (i.e. debris that could block vent openings) and take steps to ensure maximum ventilation into attic space. $88.50 0801.4085 $1.50 9001.2195 I hereby acknowledge that I have read this application and state that the informa of Minnesota Statutes and City of Eagan Ordinances. on is correct and agree to comply h all applicable State Issued By: Signature Building EA087599 11/26/2008 ePermit PERMIT City of Eagan Permit Type:Building Permit Number:EA118112 Date Issued:10/28/2013 Permit Category:ePermit Site Address: 3979 Pumice Lane Lot:20 Block: 6 Addition: Cedar Grove 5th PID:10-16704-06-200 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 . Robert Gramling 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 - Linda D Guertler 3979 Pumice Lane Eagan MN 55122 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA121493 Date Issued:04/03/2014 Permit Category:ePermit Site Address: 3979 Pumice Lane Lot:20 Block: 6 Addition: Cedar Grove 5th PID:10-16704-06-200 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 - Linda D Guertler 3979 Pumice Lane Eagan MN 55122 Clear Choice Restoration 487 Owasso Hills Dr Roseville MN 55113 (612) 226-7170 Applicant/Permitee: Signature Issued By: Signature