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3990 Riverton Ave CITY OF EAGAN Remarks Sew COI1ri pd. OI1 12-29-72 Wt3,` COT1T1. pd. 021 4-25-73 Addition edar Grove 8 Lot 7 Bik 5 Pa,cei 10 1 b707 070 05 Owner. ,eet 3990 Riverton Ave. State Eagan,M 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK LS 1 1 * SEWER LATERAL Z'L ~ 1 .1O P3'I.d WATERMAIN # WATER LATERAL 1974 1 5 WATER AREA ~E^ STORM SEW TRK 19711 STORM SEW LAT ~ CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILOING PER, SAC PARK INSPECTIUN RECORD CITY OF EAGAN PERMIT TYPE: ' 1 3830 Pilot Knob Road Permit Number: 0, Wie I Eagan, Minnesota 55122-1897 Date Issued: 'i y f''' • (612) 681-4675 SITE ADDRESS: APPLICANT: , i. tVf F7'fnN AVF il-iM; 11411;1 i I Ili':I' 1'J i~,'t ;2. 1 FI <; • I PERMIT SUBTYPE: TYPE OF WORK: INSPECTION D. . . I r ~~M ~ NF, i 1 r~a;•, ~ L~ ~ Permit No. Permlt Holdw Deb Telephone N ELECTRIC PLUMBING HVAC tnspecUon Date Insp. CommeMs FOOTINGS FOUND FRAMING ROOFlNG ROUGH PLUMBING PLBG AIR TEST ROUGH HEATiNG GAS SVC 7EST INSUL GYP BOARD FlREPLACE FIREPLACE AIR TEST FINAL PLBQ FINAL HTG ORSAT TEST sLoG Fiw?L BSMT R.I. BSMT FINAL DECK FTG DECK FINAL YILLACE OF EAGAN SEWER SERV3CE PERMIT 113 3795 PilotKnahRoad PERMIT 12/ NO.: DATE: 29/72 ~2K~7 Eagan'. MN 55122 - 1 Zoning: R 1 No. of Uni[s: owner: Grove Construction Co. pddcess: p Riverton Avenue Site Addm ~ . Plumber: S S 260.0o pd I e9m p wmply with fM V{Ilape of Eagon Connection Chazge: Ordinoncal Account Depoeit: d 1 Z~29 1 permit Fee: 10 00 p 5urchazge: 50 Ad 12/29/ Misc. Chazges: By: Total: Date of Insp.: Dace Paid: lnsp.: - Ue.1(;nul unclez I- N C #`S EAGAN TOWNSHIP L BUILDING PERMIT N? 2929 Ownei 3Sc!.-.c....... Eagan Townahip Address (Preaent) .....-./..~,.......:6........ Town Hall Huilder Dele .....Address • . DESCRIPTION 5toriea To Ba Used For Fron! Dapih Hetgh! Esl. Cos! " ezmi! Fee Aemasks 19 49A... ~ 3tZ „-0 id ~ i7i s LOCATION Slreef, Aoad or oihet Desoripfion oi Localion I Lo aek Addilion or Trset ~ `f ljS~ ~ 5• This permif does not auShorisa the vee of slraels, roads, alleys or sidewalks nor does it give the owasr or Lia sgan! ' the sigh! !o ereale anp eiluation whieh is e nuieanee os which psesenls a hasard fo ffie heallh, safely, eonvenianca aad geae:al welfare !o anpoae in the eommunitp. THIS PERMIT ASUST BE KEPT ON HE PREMISE WHILE THE WORK IS IN PROGAESB. ~ 1'his u!o eartifp, lhat...__`~.G-.....R.'~c*~ ------!~.^.!r.-~.has pesmission !o ereet a------ ..4.-_-~°'•-`--~-`..~. . . " . . up n the above deseribed premise subjac! !o the provlaions of the Suilding Ordinanea far Eagan Towrnship ado ad Apsil 11. 1955. l'~<,..Z•-' ~L . ~n ~ ~ /f ti l=:.. ~ --Par .................--.....---'-•(/.:c~~e.",_~.-••- ' , !.'hHi man o wn ard 8uildinq Impecior _ , :5- X c. 4. ~ VTLLAGE OP' r1kLAN 3795 Pilot Knob xoad Eagan, Niinn-sota 55122 PMMIT tVO. 338 The Village o£ Eagan hereby grants to Cedar (3rove Car?atructian Co. _ of 7343 Concord Blvd. Eset, South St. Paul T 6 Permit for: (py,m~) eame 3 , 392 3880 Alvertonj 9-3, . - _ , - , - 37~tirane 15-6f 3t _1718 xaWWeuv 9.8 ca fBy Pux'suant to application dated 4/23/73 Fee Paid: 1 dated this 2 th day of ApT11 3.5080 . ~ . Bu d ng Inspector hechanical Permits: r3id Total; ~i (o , VILLAGE OP EAGA1V 3795 Pilot Knob Hoad Eagan, Minn°aoLa 55122 PERDIIT N0. 328 The Village of Eagan hereby grant% to Cedar arovm CG¢18truatlon Co* oi 7343 Caanaord Blvd. Eaet, 3aaith 3t. Pau2 a pLUlIDIN6 Permit fcr: (Owner) saWe 3§90, 39249 3849, 39909 3880 xivertan 9-3 11-3 7-5~- 3) ~17~o Coahrme a.pyo 1K~- t778 Mmtte lq~pags~nt to appiication ~ted 11/23~3 • Fee Paid: $14n_M dated this 25thday of AM-il 3.50 s/c Building Inspector Mechanical Permits: Bid Total: fo gO5°7 5;10-~ 2007 "SIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone tf 651-675-5675 FAX # 651-675-5694 New ConsW ction Renuiremen5 RemodeVReuair Reauirements OKce~.Use Onlv 3 registered ste surveys shovnng sq. ft of IoL sq. ft of house; and all ioofed areas 2 copies of plan shuxirig foofings, beams, josls Cert oi Survey Recd _ Y_ N (20%maximum lot coverage a0owed) 1 set of Eicergy Calculatlons for heated addi6ons Sals RepoA _Y _ N 1 Sails RepoA if proposed huilding is N be placed an disWrbed soil 7 site survey kr additions & decks Tree Pres Plan Recd _Y 'N, 2 copies d plan shovring Oeam 8 window sizes; poured fowM desi9n, etc. Addifion - intlicate i(on-ste sepflc sysfem Tree Pres Required ' Y_ N 1 set M Eneryy Calculations On-sNe Septic-System Y _N 3 capies d Tree Preservatian Plan itlW platted after 7l1193 Rim Joist Detail Op6ons selectlon slieel (6uildrps wilh 3 a less units) Minnegasw medianiwl ventilation foim . Plans are considered ublic information unless ou state the are trade secret and the reason. Date W~ n Cons[ructionCost n~D~Y~I ~sd~, Site Address 3 990 1'~ I\/P_Y+oh AVehvP Unit/Ste t! 1 ~ Description of Work K 0 OIfn,U 1 nc~0 C Y~ Yb v~-17 Multi-Family Bldg _ Y& N Fireplace(s) ~j 0 _ 1 _ 2 Property Owner `VWLpS Telephone # ((M ) `t'S`~ 410tI Contractor kOYY,~Q OW Aw Address CitY State Zip Telephone # ( ) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672 Energy Code Category • Residen6al Ventilation Category 7 Worksheet • New Energy Code Worksheet (4 submissiontype) Submitled Submitted • Energy Errvelope Calculations Submitled In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a masier plan? _ _ Y _ N If yes, date and address of master plan: Licensed Plumber Telephone # Mechanical Contractor Telephone ) Sewer/Water Contractor Telephone # ( ~ I hereby apply for 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, and work is not to start without a permit; that the work wi116e in accordance with the approved plan in the case of work which requires a review and approval of plans. 1loImS~Y~m Applicant's Printed Name Applica ' Signature DO NOT WRITE BELOW THIS LINE Sub Tvpes ? 01 Foundation ? 07 OS-plex ? 13 16-plex. ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 27 Porch (3-sea.) ? 31 Ext. P,It - Multi O 03 Otof_plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn.(4-sea.) ? 33 Ext.Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebolpergola) ? 36 Multi Misc. ? OS .03-plex ? 17 10-plex . ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex ? 25 Miscellaneous Work Tvpes ? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 32 AddNon ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration ? 37 Demolish Building• ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement 'Demolition (Entlre Bldg) - Give PCA handout to applicant DBSCrIpt10I1: Water Damage _ Yes Valuation Occupancy MCES System Plan Review 100% or 25% Census Code Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const Width REQUII2ED INSPECTIONS _ Footings(new bldg) _ Sheetrock _ Footings (deck) _ Final/C.O. _ Footings (addition) _ Final/No C.O. Foundation HVAC Drain Tile O[her RooF _ Ice & Water _ Final _ Pool Ftgs AidGas Tests Final _ Framing Siding _ Stucco Lath _ Stone Lath _Brick _ Fireplace _ R.I. _ Air Test _ Final _ Windows _ Insulation _ Retaining Wall Approved By: , Building Inspectoe Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total ' INSPECTION REC4RD CITYOFEAGAN PERMITTYPE: suiLorNs 3830 Pilot Knob RoBd Permit Number: 0 2 6 3 0 7 Eagan, Minnesota 55122-1897 Date Issued: 0e/ 3 0 J 9 5 (612) 681-4675 SITEADDRESS: P.I.N.: 10-16707-070-05 APPLICANT: LOT: 7 BLOCK: 5 3990 RIVERTON RVE QUALI7Y HOME WORKS CEDAR GROVE 8TH (612) 431-5998 PERMIT SUBTYPE: TYPE OF WORK: SF (MISC.) RLTERATION DESCRIPTION (EGRESS WINOtlW) INSPECTION D. . D. FRAMING FINAL 17 , ~ _ _ ~ CITY OF EAGAN PERMIT CR 6IA 3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G Eagan, Minnesota 55122-1897 Permit Number: 0 2 6 3 0 7 (612) 681-4675 Date Issued: 0 8/ 3 0/ 9 5 SITE ADDRESS: 3990 RIVERTON AVE LOT: 7 BLOCK: 5 CEDAR GROVE 8TH P.I.N.: 10-16707-070-05 DESCRIPTION: - (EGRESS WINDOW) Building?Permit 7ype SF (MISC.) Ouilding Work Type ALTERATION r \ .h t 1 ~ , REMARKS: FEE SUMMARY: VALUATIQN $1,000 Base Fee $34.75 Surcherge $.50 Total Fee $35.25 CONTRACTOR: - Rpplicant - sT. Lzc. QWNER: QUALITY HOME WORKS 14315998 0009238 HOLMSTROM CHUCK 14469 GUTHRIE AVE 3990 RIVERTON AVE APPLE VALLEY MN 55124 EAGAN MN 55122 (612) 431-5998 (612)454-4681 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply uith all applicabl2 State of Mn. Statutes and City of Eagan (lydinances. ~ - tAPPLICANT/ RMITEE SIGNATU IS ~ V:~ IG~~ URE CITY OF EAGAN 3830 PILOT KNOB RD - 55122 1J JaL50f1995 BUILDING PERMIT APPLICATION (RESIDENTIAL) 681-4675 New Conshudion Reauirements RemodeVReeair Reauirortrenta ? 3 regieEerod ske wrveys ?2 copies of plan ? 2 copiea of pkns (indude beam 8 window saes; poureA fid. design; etc.) ? 2 site surveys (enterior edtlkions 8 dedca) ? 7 energy piculations ? t energy calalatlons tor heated additions ? 3 copiea M Vee proaervation plan it lot pleked efter 7/7/93 required: _ Yea _ NO ~ DATE: 9 - 1~CONSTRUCTION COST: ~ d DESCRIPTION OF WORK: STREET ADDRESS: `f J LOT ~ BLOCK ~ SUBD./P.I.D. PROPERTY Name:l_'Ukc?cd4blQ°A? (vc^S~0Phone T sy ~r OWNER Street Address- City: ~~4~? State: SS/~ Z ~L? Zip: CoN7RAC'roR Company: nu-u- Phone l7~(6 cj License Street Address: City: Ow ~I 1PT_ State: W^/ Zip. s('~ ARCHITECT/ Company: Phone ENGINEER ~ Name: Registration M Street Address, City: State: Zip: Sewer 8 water licensed plumber: Penalty applies when address change and lot change are requested once pertnit is issued. I hereby acknowledge that I have read this application and state that the informatio is corre d agree to comply with all applicabie State ot Minnesota Statutes and Ciry of Eagan Ordinances. c Signature of Applicant: OFFICE USE ONLY CertificaUes of Survey Received _ Yes _ No Tree Preservation Plan Received _ Yes _ No OFFICE USE ONLY X . .nS BUILDING PERMIT TYPE 0 01 Foundation o 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish a 02 SF Dweiling o 07 4-plex ? 12 Mufti RepaidRem. 0 17 Swim Pool 0 03 SF Addition o 08 8-plex a 13 Garage/Accessory ? 20 Public Faciliry 0 04 SF Porch o 09 12-plex ? 14 Fireplace o 21 Miscellaneous 0 05 SF Misc. 0 10 = plex o 15 Deck WORK TYPE 0 31 New 33 Alterations ? 36 Move 0 32 Addition o 34 Repair ? 37 Demolition GENERAL INFORMATION Const. (Actual) Basement sq. ft. MC/WS System (Allowable) Main level sq, ft. City Water UBC Occupancy sq. ft. Fire Sprinklered Zoning sq. ft. PRV # of Stories sq. ft. Booster Pump Length sq. ft. Census Code. Depth Footprint sq. ft. SAC Code Census Bldg Census Unit APPROVALS Planning Building Engineering Variance Perrnit Fee Valuation: $ Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit SNV Pertnit S/W Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: % SAC SAC Units " MASTER CARD LOCATION Sy~ p~9 gQ / -,s A:P OWNER STRUCTURE AND LAND USED AS Issued To Permit No. Issued Con}ractor Owner BUILDING 19 Pq PLUMBING 3}d i - CESSPOOI - SEPTIC TANK WELL ELECTRICAL HEATING ---3't13- GAS INSTALLING SANITARY SEWER OTHER OTHER I Approved Ifems (Initial) Date Remarks Distance From Well rOOTING .1~ '~r•)S $EPTIC FOUNDATION CESSPOOI FRAMING TILE FIELD FT. FINAL ELECTRICAL DEPTH HE,4TING OF WELL GAS INSTALIATION SEPTIC TANK GESSPOOL DRAINFIELD PLUMBING WEIL SANITARY SEWER I~ - a - Violations Noted on Back COMMENTS: I L COMPLIANCE INSPECTION REPORTS TO BE USED ONIY IN EVENT OF OBSERVED VIOLATIONS PERMIT NO. DATE OF INSPECTION CONDITIONS OF CONSTRUCTION AT THIS INSPECTION ? NO EVIDENCE OF NON-COMPLIANCE ? NON-COMPLIANCE. BUILDER DOES NOT OBSERVED. INTEND TO COMPLY. ~ ACCEPTABIE SUBSTITUTIONS OR DEVIATIONS. ? COMPLETION OF CERTAIN IMPROVEMENTS WILL BE DELAYED BY CONDITIONS BEYOND CONTROL. ? NON-COMPLIANCE. BWLDER WILL COMPLY WITHOUT DELAY. ITEMIZFD AND DESCRIBED AS FOLLOWS: ? REINSPECTION REQUIRED DATE OF REINSPECTION REINSPECTION REVEALED CE RTI FICATION - I certify that I have carefully inspected the above in which I have no interest present or prospective, and that I have reported herein all significant conditions observed to 6e at variance with ordinances of the Town of Eagan, aDProved plans and specifications, and any specific require- ments for off-site improvements relating to the property inspected, ? ALL IMPROVEMENTS ACCEPTABLY COMPLETED BUILDING INSPECTOR OATE COMMENTS: ~.za , • EAGAN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 PER14ET FOR WATER SERVICB CONNHCTION nate: 4/25/73 (12/29/72) Number: llitodtft 1167 7'~ g Billing Name:Cedar Grove Condtruction Site Address:-5-7--8 Owner: same Billing t7ddress 3990 Riverton Avenue Plumber: Stein's Location of Connection Meter Size Coanection Chg.7_ Meter No. Permit Fee10.00 pd 12/29/72 Meter Reading Meter Dep. •50 pd 12/29/72 Meter Sealed: Yes Add'1 Chg. NO Total Chg. Inspected by Date Building is a: Remarks: xx Resideace ~ Niultiple xo. Unita FOR IMPZOPE;1) ` Commercial -c~7~ . a. Induatrial By: Other Chief Inspector In conaideration of the isaue and delivery to me of the above permit, I hereby agree to do tte proposed work in accordance with the rules aad regulatioas of Eegan Towaship, Dakota County, Minnesota. By: stein's Please notify the above office when ready for inspection and connection. maritVoFeagan 3830 PILOT KNOB ROAD. P.O. BOX 21199 BEA BLOM9Ui5T EAGAN. MINNESOTA 55121 Mw« PHOfVE: (512) 454$100 TFiOMAS EGAN - JAME$ A. SMIiM DATE: November 6, 1985 JERRV iHOMAS TKEooor<ewacHTea - Counn Memocvs THCMA$ HEDGE$ " GtY AtlmrtusrtOfp EUGENE VAN OVERBEKE SPECIAI. ASSESS?fEVT 5&4RCA c.+rc~r. Requested by: Stewart Title RE: Cedar Grove Co of MN Lot 7 Block 5 Suite 214 8609 Lyndale Ave South ' Bloomington MN 55420 Enclosed herein is the search which you requested made on the above described property. Kind of ImDrovement yPa.,- Beginning Original Anount Balance Due NONE 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 Impzovenient ApDroximate Date of Completion Anproximate Cost N6NE WAIVER• Neither the City of Eagan nor its employees guarantees the accuracy of the above infor- mation which was requested by the person or persons indicated. Nor does the City or its employees assume any liability for the correctness thereof. In consideration for the supplying of the indicated information in the above form and for all other consideratio of any nature whatsoever, any claim against the City or its employees rising therefrom is hereby expressly waived. Levied assessments to be paid to the CITY OF EAGAN, 3830 Pilot Knob Road, P. 0. Box 21199, Eagan, MN 55121. .Very truly yours, SPECSAL ASSESSMENT DIVISION THE LONE OAK TREE...iHE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNIiY CITY USE ONLY L / BL ~ RECEIPT ~ SUBD. &4A ,3COTJe-- 0 DATE: 40/061 7996 MECHANICAL PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Piease complete for: ? single family dwellings ? townhomes and condos when permits are required for each unit New construction Add-on furnace ~ Add-on air conditioning Add-on airexchanger, i.e. Vanee system, etc. , Date: ,;ae__ Zb 19 0i FEES ? Minimum Fee: Add-on/Remodel (existing residence only) $ 20.00 ? HVAC: 0-100 M BTU 24.00 Additional 50 M BTU 6.00 ? Gas Outlets (minimum of 1 required @$3.00 each) ? State Surcharge .50 TOTAL C41 00 ` s U SITE ADDRESS:-, OWNER NAME: nJ/~ ~u+A`c- I~IGrtS'~~- PHONE INSTALLER NAME: STREET ADDRESS: k` CITY: vi S STATE: ZIP: 313 PHONE (6i?,) Q35- IS`S-.~ ~~~~fURE ~ ~T~ ~F~ flTf CITY USE ONLY L _ BL _ RECEIPT SUBD. DATE: 1996 MECHANICAL PERMIT (COMMERCIAL) • CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: ? all commercial/industrial buildings. ? multi-family buildings when separate permits are n-Qi required for each dwelling unit. DATE: CONTRACT PRICE: WORK TYPE: NEW CONSTRUCTION INTERIOR IMPROVEMENT DESCRIPTION OF WORK: FEES: ~ $25.00 minimum fee Qr 1°/a of contract price, whichever is greater. ~ Processed piping - $25.00 w State surcharge of $.50 per $1,000 of permit fee due on all permits. CONTRACT PRICE x 1 % PROCESSEl7 PIPING STATE SURCHARGE TOTAL SITE ADDRESS: OWNER NAME: TELEPHONE TENANT NAME: (iMPROVEnneNrs oNLv) INSTALLER: ADDRESS: CITY: STATE: ZIP: PHONE SIGNATURE: SIGNATURE OF PERMITTEE CITY INSPECTOR Use$LUE or BLACK Ink �------------------ � For Office Use � � j Permit#: ���/// j C�t of�ao�� � . . la �.�� � � b Permit Fee. 3830 Pilot Knob Road � � Eagan MN 55122 � Date Received: j Phone: (651)675-5675 I 1 Fax: (651)675-5694 I Staff: I I I `_________�����__J 2014 RESIDENTIAL BUILDING PERMIT APPLICATION ` `' , /� Date: � ��' �`I" Site Address: ��RO � r�'�I�ul� t'11�(l� Unit#: n����� ��� — ���������� � �� Name:�' �Y'�Q.S G�,Yt� �D��Q111 t��►�►Sl�m Phone:���—•d� I�Q'"��� 1 ' ReSlden�ta,� ���� q � � C ✓�-� �,C 1'1A��s� QYy11�?t` ` ' Address l City/Zip:�1�� 1 V�QY'�On �1PQ,Y1l1.Q �G\��rl �J��oC i,,� ��, : �� � Applicant is: �Owner Contractor i , �� � i v (� Description of work: � I ( S C�T �a '�yp�t��rNOr[c�� � �. ,i�z �� �� � �f ; �� Construction Cost: ��, �� Multi-Family Building: (Yes /No� � �`���' Company: Contact: ti� °� ' Address: City: � �41f1t�'�C#t3C ������� State: Zip: Phone: Email: License#: Lead Certificate#: If the project is exempt from lead certification, please explain why: (see Page 3 for additionai 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 8�Water Contractor: Phone: NL1TF:Plarts a��t sr�ppqi�i�tg doc�rn�t�t�.fhat,yc�tr;�u6rttif ar'e c4�5id'eCec��c���i�'�'',,��i+�lEC°�rtform��ron� t�ci�r���-o�'��I';��` #he�nfarmatran r►�ay�be��:l�s�rf�e+d�s rio,��ub�'ic�f��u,prc��ra(e spe��f�c�r�as+�r�s�l��#,wr��ld�aeim�Yi�t�e�Cr#�tc�,��a � cc��C�iide tha�tl�e �ar�t�rade���refs. ��� � ����,t��' � , � ��,.. . ,_,�s� � �, , ��� � ,�, ��y � � ����o��� � � . � � � ������ � �� _ 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.aooherstateonecall.ora 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. � �^C�L�l�.�9�+ X �����rl ��YY1�Y'b I�. X ��-- Applicant's Printed Name Appl ant's Signature Page 1 of 3