1410 Rocky Lane)WATER PERMIT
C- 7 . AN
3830 Pilot Knob Rd.
Eagan, MN 55122-1897
DATE OCT 11, 1990
METER # -
CHIP # -
METER SIZE
ISSUE DATE
X NEW
- PRV - BOOSTER PUMP
SITE ADDRESS 1410 RkX'KY LN
LOT S BLOCK 4 SEC/SUB CUTTERS RIDGE 1ST
APPLICANT:.
ADDRESS:
CITY, STATE
PHONE:
PERMIT REQUESTED
X SEWER X WATER TAPS
COMM/IND
ZIP
PLUMBER: D C MECHANICAL
ADDRESS: 4253 W 140TH ST
CITY, STATE SAVAGE, HN ZIP 55378
PHONE: 894-2778
OWNER: KBYI-4ND HOMES
ADDRESS: 14450 BURNSVILLE PKWYK
CITY
STATE BURNSVILLE, MA ZIP 55337
,
PHONE: $Q4-2636
X RESIDENTIAL
EXISTING
Lawn Sprinkler Meters are to be Installed
Ahead of Domestic Meters on Water Line.
Credit WILL NOT be given for Deduct Meters.
EAGAN
USE ONLY
PERMIT DATE 10/16/90
PERMIT # 116$1
B.P. RECEIPT #? l
B.P. RECEIPT DATE 101151 0
CITY OF
SIGNATURE WHEN METER ISSUED
PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT.
CASH RECEIPT
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE 1o115-,9 -
RECEIVED
FROM
\1
AMOUNT S
8 DOLLARS
6,oo
? CASH CHECK
Thank You
By ?-4
C 0 O/? 7 WAke-Payers Copy
Yelbw-Postktg Copy
Pink--File Copy
SEWER & WATER PERMIT
CITY OF EAGAN
3830 Pilot Knob Rd.
Eagan, MN 55122-1897
DATE OCT 11 1990
OFFICE USE ONLY T?
METER # PERMIT DATE to/ 16/90
CHIP PERMIT # 11681
METER SIZE 12C_4 B.P. RECEIPT #L I
ISSUE DATE l y- I - B.P. RECEIPT DATE 101151 0
PRV -BOOSTER PUMP
SITE ADDRESS ` 1410 ROCKY LN
LOT S BLOCK 24 SEC/SUB CUTTERS RIDGE ]ST
APPLICANT:.
ADDRESS:-
CITY, STATE
PHONE:
ZIP`.
PLUMBER: D C MECHANICAL
ADDRESS: 4253 W 140TH ST
CITY, STATE SAVAGE., MN ZIP 5537".
PHONE: 894-2778
OWNER: KEYLAND HOMES
ADDRESS: 14450 BURNSVILLE FKWYK
CITY, STATE BURIISVILLE, KN ZIP 5
PHONE: 3P4--2636
PLEASE ALLOW TWO WORKING DAYS FOR PROCEE
SEWER PERMITS, CONTACT ENGINEERING DEPT.
PERMIT REQUESTED
X SEWER R WATER TAPS
COMM/IND X RESIDENTIAL
X NEW
EXISTING
Lawn Sprinkler Meters are to be Installed
Ahead of Domestic Meters on Water Line.
Credit WTLt NOT be given for Deduct Meters.
Y WITH OWY OF
SIGNATURE WHEN METER ISSUED
CALL 4545220 FOR INSPECTIONS. FOR STORM
13-10 1114
.. ; -?? •.?r-.R.ar<¢ :.r .K ......?n.,.y,?..,.??'+'???.ti?,ysi'^?iev.7sr?---••+?^r„?e,^ . ....'F7i?'`1'_c1??
CITY OF EAGAN ?8?4?
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 '« .
PHONE: 454-8100
BUILDING PERMIT Receipt #
To be used for SF DWG/GAR Est. Value $96,000 Date OCT 11 19 90
Site Address 1410 ROCKY LN
Lot 8 Block 4 Sec/Sub. CUTTERS RIM 1S
Parcel No.
0: Name KEYLAND HOMES
14450 BURNSVILLE PKWY
It Address
City BURNSVILLE Phone 894-2636
o Name SAME
Address
City Phone
Name
Address
City -
Phone
I hereby acknowlege that I have read this
information is correct and agree to comp
Minnesota Statutes and City df Eagan Ordir
Signature of
i and state that the
applicable Slate of
on the express condition that all work shall be done in acFordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official
OFFICE USE ONLY
Occupancy R-3 M-1 FEE S
Zoning R-1
V-N 622.00
(Actual) Const Bldg. Permit
(Allowable) V-N Surcharge 48.00
# of Stories
46'
Plan Review
404.00
Length -
100.00
Depth SAC, City
S.F. Total SAC, MCWCC 600.00
S.F. Footprints 625.00
On Site Sewage Water Conn
On Site Well Water Meter 90.00
MWCC System X 30.00
City Water X Acct. Deposit
30'?
PRV Required S/W Permit
Booster Pump - S/W Surcharge .50
252.00
Treatment PI
APPROVALS Road Unit 355.00
Planner Park Ded.
Council 50
Bldg. Off. Copies
3 157.00
Variance TOTAL
Permit No. Permit Holder Date Telephone #
WATER
SEWER
PLUMBING X( /?C.• /?t? `f?L?
H.V.A.C. j?
ELECTRIC
Inspection Date Insp. Comments
Footings I
Foundation ?_ l z 45
Framing ??/ 3 f0 [/S S., ?r. ?c ?? 1C LS
Roofing
Rough Plbg. 1
Rough Mg. !/J 3 9d
Isul. ?S
Fireplace
Final Htg.
Final Pibg. W,sue ,(t
Const. Meter Plbg. Inspector - Notify Plumber
EngrJPlan
Bldg. Final z ?-I -pe, ?$
Deck Fig.
Deck Final
Well
Pr. Disp.
?' yr..'.rb-
Tntifiratt of (Orrupoury
Cctp of Cagan
Rrmum t of Wailm" -3mTritimt
V= C;uvrwate issued pursuant to the requirements of Sewon 306 of the onfforn Building
Code certifying that at the time of issuance thirst wawe was in campS=e with the various
on i=A= of the a 0v regukr&g building construction or use. For the following.
Uae ewac. SF DI,1G/GR DWS- F=mk Na 18449
Omo•qTyw MAC Zoaing136hia R1 Type C. VN
Owsw of LIacrmg KEY[ AM ASS Add,,. 14450 B'ViM2W, B'VTLi.E
-.,.--- 141() RrVTV TANE IS. B4. aR= RIDGE 1ST
DeMeM 21, 1990
POST IN A CONSPICUOUS PLACE
CONTRACT
PRICE
Site Address
Lot K
Add
a City
c Address
8 City
Phone
FEES
COMMAND. FEE - 1% OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE $12.00
MINIMUM - COMM.IND./FEE $20.00
STATE SURCHARGE PER PERMIT .50
(ADD $.50,9/CPER EACH $1,000 OF PERMIT FEE)
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122
PHONE 454.8100
BLDG.TYPE
Res. -'f
Comm.
Other
For
PERMIT #,
RECEIPT #
DATE: /
New Cc
Add-on
Repair
NO. FIXTURES TOTAL
Water Closet - $3.00 $ o O
Bath Tubs - $3.00 -7-00
Z Lavatory - $3.00 5,00
Shower - $3.00
Kitchen Sink - $3.00a?
Urinal/Bidet - $3.00
Laundry Tray - $3.00
Floor Drains - $1.50
Water Heater - $1.50
Whirlpool - $3.00
Gas Piping Outlets - $1.50
(MINIMUM -1 PER PERMIT-NEW CONST.)
Softener - $5.00
Well - $10.00
Private Disp. -$10.00
Rough Openings - $1.50 71.
U. G. Sprinkler System - $12.00
PERMIT FEE:
STATES S/C:
GRAND TOTAL:
^w'sN•..Yp:,r^ :r??x;+?`???4'. f..f: ?1\? a ?-:;7) •{???..t ,. t.. .
PERMIT #?
MECHANICAL PERMIT RECEIPT #
CITY OF EAGAN //Al
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE
CONTRACT PRICE: PHONE: 454-8100 For Office Use Only:
Site Address ' C>
BLDG. TYPE WORK DESCRIPTION
Lot Block Sec/?
Res. New
Name %K u a
Mutt Add-on
m Address 6 W E L c'?r •t ?i. St Comm. Repair
Oth
r
S City t;_ 4f( ,; e? lv a Phone yy ?. 7
e
FEES
Name 'RES. HVAC 0-100 M BTU -$24.00
c Address / ` %? ! ?U ' v• / ? k w ADDITIONAL 50 M BTU - 6.00
p City
Phone a? b (RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS (MINIMUM - 1 PER PERMIT) - 1
50 EA
.
TYPE OF WORK COMM/IND FEE - 1% OF CONTRACT FEE
Forced Air 71,Q60 M BTU " ac APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONDOS - RES. RATE APPLIES
Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
Unit Heater M BTU REMODELS - 12.00
00
MINIMUM COMMERCIAL FEE - 20
Air Cond. M BTU .
STATE SURCHARGE PER PERMIT - .50
Vent CFM (ADD $50 S/C IF PERMIT PRICE GOES
Gas Piping Outlets # J • = BEYOND $1,000)
Other
4 ')
--
!
FEE ,N./
s -- 1 n.?4_•-
SIGNATURE OF PERMITTEE
SIC
: .56
TOTAL `' FOR: CITY OF EAGAN
RE:
DATE:
OCT 16, 1990
1410 ROCKY LN (KEYLAND HONES)
x Your Sewer & Water Permit for the above property has been completed. It will be held at the
Public Works Garage (3501 Coachman Road) until the meter is picked up. BE SURE TO
CALL PUBLIC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON.
Your Sewer & Water Permit for the above property cannot be completed for the following
reasons:
Your Sewer & Water Permit for the above property has been completed, but the meter cannot
be issued or occupancy allowed until further notice.
COMMERCIAL PROJECTS ONLY: Please pay for meter at City Hall. Meter size must be
confirmed by Bill Adams or Dirk House (Plumbing Inspectors - 454-8100) before issuance.
WARNING: BEFORE DIGGING, CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC.
- REQUIRED BY LAW.
CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY.
Secretary, Building Inspections Dept.
Address: 1410 PDM LANE
Lot g Blk 4 Sec/Sub CUTTER
eta at the time of the final
Yes No INSPECTOR: Ci
RIDa IST
These items were/were not
DATE: DECIIM 21, 1990
Final grade (6" from sidi
Permanent steps - garage
Permanent steps - main an
Permanent driveway
Permanent aas
damage
Porch
Basement finish 1/ 3 Lg L-l ?r7n;dy
Deck !
Please verify with the builder the removal of roof test caps from the plumbing
system and the shut-off of water supply to the outside lawn faucet before
freeze potential exists.
White - City copy Yellow - Resident copy Pink - Contractor
CITY OF EAGAN NO 18449
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
BUILDING PERMIT PHONE: 454-8100 Receipt # /bll L/ f Om
To be used for SF DWG/GAR Est. Value
000
Site Address 1410 ROCKY LN
Lot 8 Block 4 Sec/Sub.CUTTERS RIDGE 1S!
Parcel No.
w Name KEYLAND HOMES
c Address 14450 BURNSVILLE PKWY
City BURNSVILLE Phone 894-2636
o Name SAME
0.< Address
E City Phone
wW Name
u3 Address
`aw City Phone
I hereby acknowlege that I have read this application and state that the
information is correct and a, a to comply with all applicable State of
Minnesota Statutes and Ci gan,Ordinanc s
Signature of Permitee
A Building Permit is issued to: KEYL D HOM S
on the express condition that all work shall b done in a ordance with all
applicable State of Minnesota Statutes and ty of Eagan Ordinances.
Building Official ??Dy)4 "OAA 1 1411
19 90
OFFICE USE ONLY
Occupancy R-3 MM1 FEES
Zoning R--i
(Actual) Const VN Bldg. Permit ---622- 00
(Allowable) V-N Surcharge 48.00
# of Stories
46
Plan Review
404.00
Length
Depth 50, . SAC, City 100-00
S. F. Total SAC, MCWCC 600-00
S.F. Footprints -
On Site Sewage Water Conn 6+25 - r10
On Site Well Water Meter 90.00
MWCC System -X-
Accl. Deposit
30.00
City Water X
PRV Required S/W Permit 30.00
Booster Pump SAN Surcharge
0
.5
Treatment PI 252.0
0
APPROVALS Road Unit 355.00
Planner Park Dad.
Council -. 50
Bldg. Off. Copies .
Variance TOTAL 3.157.00
// S 9 0
l
3 4114 S
y
Request Date Fire No. Roughen Insp tlion
R iretl?
? Ready Noww? Will Nofiry Inspector
Yes ? No When Ready?
ICensed contractor ? owner hereby request inspection of above electrical work at:
Job Address (Street, Box or Route .) City
Section No. Township Name or No. Range No. only
Occupant(PRINT) Phone o.
PowerS I' r Atltlress
EIe0alga Contratlor (Company Na I Contratlor§ nse No.
D Ss
Mailing AOtlres Contratlor or Owner Making I
?76 7S GtJ nstallaton)
/3
Aulhorizetl -nature (COntrad Own r Making Installation( 1-1 Phone Number
a?
MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
Grlgg0,11111Gway Bldg. - Room ^s173 BE ACCEPTED BY THE STATE BOARD
1821 Unlvemity Ave., St. Paul, MN 55100 UNLESS PROPER INSPECTION FEE IS
Pitons (612) 6020(100 ENCLOSED.
111q/90
H 34114
REQUEST FOR ELECTRICAL INSPECTION
11, See bstructions 1br oomplehing this form on back of yellow copy.
"X" Below Work Covered by This Request
Jr.v" EB-00001-08
New Add Rap. :-? Typeof Building AppliancesWired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Other (Specify)
Comm./Industrial ' Furnace
Farm Air Conditioner
other (specify) Contractor's Remarks'.
Compute Inspection Fee Below.
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool O to 200 Amps 0 to 100 Amps
Transformers Above 200 Amps 00 _ Amps
Signs Inspector's Use Only: 7
t'J
TOTAL
Irrigation Booms
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee o COMPLETED WITHIN 18 MO
I, the Electrical Inspector, hereby Rough-in - Oate'I .r "?
-i
certify that the above inspection has
been made. Final Oa
rk
3?G
OFFICE USE ONLY
This request void 18 months tram
0•*
622.00+
48.00+
404.00+
0.50+
2,082050+
3,157.00*+
622.00+
48.00+
404.00+
0.50+
2,o82-50+
3,157.00*+
1990 BUILDING PERMIT APPLICATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS MULTIPLE DWELLINGS COMMERCIAL
2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS
_# OF RENTAL UNITS
# OF FOR SALE UNITS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED,
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
To Be Used For: Valuation: 76i 000 Date
Site Address > GCz?'ILPTaA
Lot F-) Block
Parcel/Sub
Owner ?T11?t?1i7^??vS
Address `lkuC-;c \` Fz XC W \ I
City/Zip Code 0-'5ZATV-)4wAT
Phone ???!>
Contractor
Address
City/Zip Code
Phone
Arch. /Engr? ^t'??Y?? ?q lS?
Address CEC?1 Li?RSA 2? >?
City/Zip CodeC
Phone #
vt- 0 3 REGO
k 0?0
Occupancy
Zoning
Actual Const
Allowable
# of stories
Length
Depth
S.F. Total
Footprint S.F
OFFICE USE
R-3 M-1
R-1
V-N
V-114
Y
On site sewage_
On site well _
MWCC System
City water v
PRV _
Booster Pump
APPROVALS
Planner
Council
Bldg. Off. 1?/9
Variance
FEES
Bldg. Permit ZZ.O0
Surcharge ga.00
Plan Review / ,OJ
SAC, City
0
/00,0
SAC, MWCC 600100
Water Conn 625,00
Water Meter 0,00
Acct. Deposi t 30.00
S/W Permit 261
S/W Surcharg e ,SO
Treatment Pl . 252,00
Road Unit 3566100
Park Ded.
Copies
SUBTOTAL
Penalty
TOTAL
J5 ad 4)
1/AUAATIOQp
GA?2A[rf=' t
Zyx22s 5Z8 x t5= 7920
SSM T.
4x 14( 2 'A 2y ? yg
X $ (o'?
t d3 8 X /LI= /831Z
ak-tl 2X/oK?y ZS-?o
HoL. be
T3am T . 13 2B'
2 ? `6
t 3 y? x .5l - 6.?y `?
R5, ash
SEP-19-'90 WED 12:46 ID:JAMES R HILL INC TEL NO:612 684-9518 11474 P04
1410 ROCKY LANE 3412-A
SURVEYOR'S CERTIFICATE KEYLANO HOMES'
Ito
N 84° 51117' "W
JDQ i 146.18 I 0
n
Q v
?Q.q 10 f 8 V 01 ?- '?• n i
10 1
_ boy >
e N I'W P O 130.33 I
?e > o a Q: Ip J
?
\ o who as 8 V
0
i? i<0 M > 0
Q O 4 3
I
8 i o m
z 1 to L 111rM J O ?r
N mr a ' C
O
10
30
I ^ 163.21 "?" „ / i•.
N 84° 51,17' W
V
By
to _ NENG
EAC
AX EERIIVG DEPT
• DENOTES PROPOSED SURFACE DRAINAGE'
O DENOTES IRON MONUMENT SET SCALE: 1 INCH - 30 FEET
• DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR - 9o&. z FEET
X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR - 9os4 FEET
(000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK- fob.(. FEET
WE HEREBY CERTIFY TO KEYLAND HOMES THAT THIS IS A TRUE AND CORRECT
REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF:
Lot 8, Block 4, CUTTERS RIDGE IST ADDITION, according to the recorded plat thereof,
Dakota County, Minnesota.
IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENC^OACHMENTS, EXCEPT AS SHOWN. AS
SURVEYED BY ME OR UNDER MY DIRECT SUPERVISION THIS 19TH DAY OF SEPTEMBER , 1990.
. J S R. HILL, INC.
PROPOSED GRADES SHOWN WERE SIGNE
TAI?i FROM THE DEVELOPMENT PLAN
FIN E11S 11100E IST ADDITION, B
PRL1M11111) BY 1CSERT A. THENE, P.E.,
LAST DATED e - 20-e8. JOHN C. !_ARSON, LAND SURVEYOR
MINNESOTA LICENSE NUMBER 19828
'a 07
0 0 TT Jaynes R. Hill inc.
-n' 10
Om O X ? ` D
m ,
m° ro z ? Z m
'
° ? PLANNERS /ENGINEERS /SURVEYORS
p
{
{p
9401 JAMES AVE. S. • BLOOMINGTON, MN. 55431 .612-884-3029
EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION
OWNER: -- ---- ---- DATE:
_?? ?+t£?srPNONE:
SITE ADDRESS:
CONTRACTOR: ?i?i PLAN
Determine working square footage of each.
1. Total exposed wall area..... 1,7p170 sq. ft. .11 = o7ao?, a
2. Total roof/ceiling area..... 45:7 sq. ft. x .026 = ?5,yot
Total exposed wall area above .floor=_&?--
a. Total wall window area ...........................................
b. Total door area ..................................................
c. Total sliding glass door area ....................................
d. Total fireplace wall area ........................................ a?
e. Total wall framing area (average 10%) ............................
Total rim joist area.. ............................................
F
g. net wall area above floor .....................................
h. wall area above floor .....................................
i. wall area above floor ...............'......................
j. frame wall area at foundation ...................................
Total exposed foundation area=
9
k. Total foundation window area. ......................
1. Total net foundation area above grade .............._o
Determine "u" value of each wall segment
(e.g. window, door, each separate wail section)
a. 5'
b. X
c. X
d. X
e X
f . ///lo X
9. ???? X
h. X
H 1Ill
luil
UU (- _
UU, a =fit
Uti
u S,
Bull _
X "Oil
i.
j X U If item 13 is the si
k X „U„ as, or less than iti
in you have met -6 thi
X "U„ intent of SBC 6006
3 . .................................Total =%5.a3
4.'`TOTAL EXPOSED ROOF/CEILING CALCULATIONS:
Total exposed
roof/ceiling area....... ., sq ft
j) Total skylight area....... l- sq ft x "U"
Q Total roof/ceillnq framing
1
9)
(
`r s
ft
x "U" D?
Average
.....
0
area q
c ?
1) Total net insulated
roof/ceiling area.......
'145'p/-3 sq
ft
x "U"
4. TOTAL j) thru 1) 7
If total of 54 is the same as, or less than N2, you have met the intent of
2 ?SCAR 1.16005 _4 and 0.
ALTERNATE BUILDING ENVELOPE DESIGN
To utilize the total envelope system method, the values established by the sum
of items .-°3 and 94 shall not he greater than the sum of items NI and y2.
1 . aaa , + 2. 35, ?? = a5 . aa.
>1
LINEAL FEET EXPOSED WALL
BLOCK: /o' Zy /Oi Z??/ Z4o' /?+di ?5f/++ Z`l? ZP?y /YO
KNEE:
WALKOUT: Z--1
FULL 1:?i5/<??2,5?GaZ9?sZ?+3?iZ?3?L'3fZ ?Z'?C/lr.S
FULL 2: -
FIREPLACE: ,
RIM: All
SQUARE FEET EXPOSED WALL AREA
BLOCK: x .5 = ?d
KNEE: 5Z x 5 =
WALKOUT: /f1 x 8 /GfZ
FULL 1: x 8 = /33Z
FULL 2: - x 8 =
FIREPLACE: x =
RIM: /?!r
SQUARE FEET EXPOSED CEILING
WINDOWS: DOORS: zQ _ ?g
z9s? - /?? /g PATIO DOORS:
0 /// Cry lrx /v- // ?
BASEMENT UNITS:
z$,, 7-/ ? ql
SKYLIGHTS:
u'
CONSTRUCTION
R-VALJJE
1. INTERIOR AIR FILM n r,A
2. 5/8" GYP BY) cQ
3. _INSULATION A4 nn
4. EXTERIOR AIR FILM n 61
TOTAL 45.80
U = .02
FRAME
HEAT FLOW
u UP
FIG. #5
1. INTERIOR AIR FILM
2.
3. NSULATION 38.35
_
4. TTETTUR AIR FILM LH?AL 40.15
U = 0.024
CONSTRUCTION
1. INSIDE AIR FILM
fl*
f l HEAT FLOW UP
VENTED
2.
3.
4.
5. I E AIR FILM 0.17
-
FRAME
1 INSIDE
IR FILM 'T'OTAL
U =
0.61
2.
3.
4.
5 OU S
1. INSIDE
AIR FILM U =
0.61
2.
3.
4.
5. R FILM 0.17
TOTAL
U =
NOTE: USE ADDITIONAL SHEETS IF MARE SPACE IS
NEEDED FOR DETAILS AND CALCULATIONS.
FIG. #7
ROOF-CEILING
HEAT FLOW
UP
FIG. #6
Wou- secT=rt
for
1b' r Use(% 0f opaque woI1 01-120
ci fya? E C[YwSEYUCf iun
R VALUE
CONSTRUCTIOT,•- FRAMING -
1. INTERIOR AIR FILM 0.68
2. 1/2" GYPW
3. 5 2 SO WOOD 6.87
4. 25/32 SF=NG 2.06
5. SIDING .89
6. EXTERIOR R FILM 0.1
TOM R= 10.8
U= .09
F9,AMe NACC
NET
1. INTERIOR AIR FILM 0.68
2, i .4
3. 6" INSUL.
4. 25/32 SHEATHING 2.06
5. S TNG .6
6. EXTERIN AIR FILM
U= .04
:5.i Lt
1. INTERIOR AIR FILM 0.68
2. SUL. 00
3. 2x10 RIM JO
4. 25/32 SHEATHING 2.06
5. SIDING
.62
6. MMOR
U= .04
AD Axlt.A
WItI.L
fTG . 43
t
t ? 0
+
BLOCK
1. INTERIOR AIR FILM 0.68
2.
? 3. 1" STYRO 5.00
4. PROTECTIVE BARRIER
5.
6. M=OR AIR FILM 0.17
T7OTXL R= 7.13
U= .14
SLAB ON GRADE
t?
Esc. q LL
o - ?
m
v '
,., - I i I ,
0L -?c
w ? elt
.NOTE- INDICATE TYPE, "R" VALUE. DEPTH AND
PLACEMENT OF INSULATION.
6•
?k
D a
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF FAGAN
I Gi -' ` I 3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New Construction Requirements
• 3 registered site surveys showing sq. R. of lot, sq, ft. of house; and all roofed areas
(20% maximum lot coverage allowed)
• 2 copies of plan showing beam & window sizes; poured found design, etc.)
1 set of Energy Calculations
• 3 copies of Tree Preservation Plan if lot platted after 711193
• Rim Joist Detail Options selection sheet (bldgs with 3 or less units)
DATE ?-1-? --2-
Remodel/Repair Requirements
• 2 copies of plan
• 1 set of Energy Calculations for heated additions
• 1 site survey for exterior additions & decks
• Indicate if home served by septic system for additions
VALUATION -f 77oo e'
SITE ADDRESS lylo ?ac k ti CA^I MULTI-FAMILY BLDG -Y _N
TYPE OF WORK 1 C'. ie--0FF "eCyeraol- FIREPLACE(S) - 0 _ t - 2
APPLICANT S I . (Zlez r y.- V
STREET ADDRESS ?? l I 4,11 AHD 7 CITY EACC -sr?2 STATE Mh1 ZIP 4'33
TELEPHONE # 9r2 `hD - L(4o 3 CELL PHONE # `F FAX # 9CZ-`l 70 - q 4t 3
PROPERTYOWNER tJ?l?iJ ?/ J?4c ?k TELEPHONE# Grt--47-?a' 3c5'
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY I _ X{IN\ESOT:1 RULES 7672
(d submission type) • Residential Ventilation Category 1 Worksheet Submitted NeM.Submitted
• Energy Envelope Calculations Submitted ? Plumbing Contractor: ----___--__-____- Phone #
Plumbing system includes: Water Softener Lawn Sprinkle )0
Water Heater No. of R.I. Ba No. of Baths
Mechanical Contractor:
Ylechuyical system includes:
Sewer/Water Contractor:
Air Condit otung
Heat Recovery Systent
Phone #
Phone #
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 Origgnces.
Signature of
----------------------------------------- ----------------__ ---- -----_- ----- ---------------------- -
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required -
Updated 4102
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of_ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) O 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? 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 Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement *Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) Final/C.O.
_ Footings (deck) FinaliNo C.O.
_ Footings (addition) - Plumbing
_ Foundation _ HVAC
_ Drain Tile Other
Roof _ Ice & W ater _ Final _ 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
Building Inspector
Total
L BL
SUED. C k ed s ?
CITY USE ONLY
RECEIPT #:
t?
RECEIPT DATE: -CJ 0
PERMIT # 1"Iq o
2000 PLUMING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT MOB RD
EAGAN, NK 55122
651-681-4675
Please complete for: > single family dwellings
> townhomes and condos when permits are required for each unit
> backflow preventer for underground sprinkler system
FIXTURES
EACH #
TOTAL
Alterations to existing dwelling - minimum fee
Describe: $ 30.00
Bath tub $ 3.00 x = $
Floor drain 3.00 x = $
Gas piping outlet ' minimum -1 3.00 x = $
Hot tub/spa 3.00 x = $
Kitchen sink 3.00 x = $
Laundry tray 3.00 x = $
Lavatory 3.00 x = $
Septic System new/refurbished " requires MPC lie. 75.00 x = $
Septic System abandonment 30.00 x = $
RPZ new installation/repair/rebuild 30.00 x = $ '
Rough opening 1.50 x _ $
Shower 3.00 ' x' _ $
Underground sprinkler if dwelling is under construction 3.00 x = $
Underground sprinkler if existing dwelling 30.00 x _ $
Water closet 3.00 x = $
Water heater 3.00 -x = $
Water softener if dwelling under construction 5.00 x = $
Water softener If existing dwelling 30.00 x = $
Water turnaround 30.00 x $ 13b-
ate Surcharge
S .50 -> -> -> $ .50
t
Total -> -> -> - > $ :30. ?S:p
Reminder.- Call for inspections of alterations, i.e. water heaters, water softeners, etc.
- ---- --- ------- ------ --- -- --" - --------- - -----
1 hereby acknowledge that I have read this appliption, state that the information is correct, and agree to comply with all appli
It is the applicant's responsibility to notify the property owner that the City of Eagan assumes no liability for any damages by-fhei( n
normal operational and maintenance activities to the facilities constructed under this permit within City property/right.of-wa a lP.
SITE ADDRESS: 1117114 6mC.4-- Lit/ DE" 2 0 ?n0o
OWNER NAME:: TELEPHONE 87-
-- ----- REA CODE)
ER NAME: 00e! TELEPHONE #: ? ?.3 O-SSS,-
INSTALL
__ _ _RCOD_E_)
STREET ADDRESS:
CITY: STATE: ?v ZIPS -??y?
SIGNATURE OF PERMITTEE
6730 ?
2004 RESIDENTIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for: single family dwellings & townhomWcondos when permits are required for each unit
Date
Site Address Unit #
Property Owner la,1 u n IV4 11M l ` Telephone # ( GSA ) to Y 7- f
l-t
Contr_ctor
I
Street Address City RJ ?f r n "
State 0'A) Zip S$"j37 Telephone # (9sz
Bond #: 5-5-- 46 V(03 Expires: 4 J
The Applicant is Owner Contractor Other
Add-on or alteration to existing dwelling unit $ 30.00
furnace -Additional 0!k-Replacement
air exchanger
air conditioner New -Replacement
other
$ .50
State Surcharge
$ 3a
Total.
I hereby apply for a Residential Mechanical 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 with the Mechanical Codes; that I understand this is not a
perms, 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 th case of work which requires a review and approval of plane
! ,?.ervta rI >7
Applicant's tinted Name Apphcant's(YignaV7r'
2004 COMMERCIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for: commercial/industrial buildings
multi-family buildings when separate permits are mg required for each dwelling unit
Date
Site Street Address Unit #
Tenant Name (if applicable) Previous Tenant Name
Property Owner Telephone # ( )
Contractor
Street Address City
State Zip Telephone # ( )
Bond #: Expires:
The Applicant is Owner Contractor Other
Work Type
_ New Construction _ Underground Tank _ Install -Remove 'see below
Interior Improvement - Install Piping - Processed -Gas
Nature of Work:
"When installing/removing underground tank, call for Inspection by Fire Marshal and Plumbing Inspector
Permit Fees: $70.50 Underground tank installationlremoval
ZO-50 iI :n7nwn 011C1U&3 State S':reharge)
or
Contract Value $
x 1% _
$ Permit Fee
a If oerrm fee is $1,000 or less, add $.50 $ State Surcharge
If,pgrmit fee is over $1,000, add $.50 for
every $1,000 emu Fee $ Total Fee
I hereby apply for a Commercial Mechanical 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 with the Mechanical Codes; 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.
Applicant's Printed Name
Applicant's Signature
Approved By: , Inspector
3?7 3 dRESIDENTIALBUILDINGn
1 City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone 4 651-675-5675 FAX 9 651-675-5694
New Construction Requirements
3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas
(20% maximum lot coverage allowed)
2 copies of plan showing beam & window sizes; poured found design, etc.
1 set of Energy Calculations
3 copies of Tree Preservation Plan if lot platted after 711193
Rim Joist Detail Options selection sheet (buildings with 3 or less units)
Minnegasco mechanical ventilation form
RemodeVReoair Reauirements
2 copies of plan showing footings, beams, joists
1 set of Energy Calculations for heated additions
1 she survey for additions & decks
Addition - indicate if on-site septic system
C
SD160
Office Use OnN
Cart of Survey Recd -N
Tree Pres Plan Recd -_Y. _N_
Tree Pres Required ._Y N
On-site septic System .-Y -N
Date 5- 0,6_ Construction Cost Sdo ?J
Site Address / ,//,o o ` Z-,+"
2 Unit/Ste #
Description of WorkQ WY'k t' 4-C S c t of lOGR G rh TY+ ?f 0->e / O
Multi-Family Bldg _ Y `- N Fireplace(s) - 0 - ] - 2
Property Owner Telephone # ( )
Contractor 1 f r15 C> h
Address City 4ev a^ t
State Zip M{2 Telephone # COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672
Energy Code Category Residential Ventilation Category 1 Worksheet New Energy Code Worksheet
(J submission type) Submitted Submitted
• Energy Envelope Calculations Submitted
in the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
- Y - N If yes, date and address of master plan:
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #f
Telephone # (
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 will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
ktc'? ?o?ly?s?l1 44? A&4:k-
Applicant's Printed Name Applican t sStnature
DO NOT WRITE BELOW THIS LINE
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of - plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex 110?'l8 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex ? 25 Miscellaneous
Work Types
? 31 New ? 35
? 32 Addition ? 36
? 33 Alteration ? 37
M"'34 Replacem t n
Description: wate amago Yes
Valuation t-0 0
Plan Review •-_-100% or --- 25%
Census Code 43 el
SAC Units
# of Units
# of Bldgs
Type of Const
Int Improvement ? 38 Demolish Interior ? 44 Siding
Move Building ? 42 Demolish Foundation ? 45 Fire Repair
Demolish Building* ? 43 Reroof ? 46 Windows/Doors
*Demolition (Entire Bldg) - Give PCA handout to applicant
Occupancy 2_ 3 MCES System
Zoning City Water
Stories Booster Pump
Sq. Ft. PRV
Length Fire Sprinklered
Width
Footings (new bldg)
Footings (deck)
- Footings (addition)
_ Foundation
_ Drain Tile
Roof _ Ice & Water _ Final
V_?Framing
Fireplace - R.I. -Air Test -Final
Insulation
REQUIRED INSPECTIONS
Sheetrock
_ Final/C.O.
f Final/No C.O.
_ 1IVAC
Other
- Pool _ Ftgs _ Air/Gas Tests _ Final
- Siding _ Stucco Lath _ Stone Lath -Brick
Windows
Retaining Wall
Approved By: ?e L Building Inspector
Base Fee _?0000
Surcharge s0
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total 30, S0
City or Eaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
leSSIZZMI
Permit #: /0151? 3
Permit Fee:
Date Received:
Staff:
2011 RESIDENTIAL/PLUMBING PERMIT APPLICATION
Date: Site Address: [ "/ O PO et9._ L441_1
Tenant:
RESIDENT / OWNER Name,% t
Address / City / Zip: /x-110 o
Suite #:
J
Phone: &S/— -q'8,
5"S'
CONTRACTOR Name: MILBERT COMPANY INC.dba CULLIGAN WATER
Address:
State: ' MN
Contact BILL .MILBERT
1801 SOTM ST EAST
_Zip:'' 55.077 Phone: 65.1:;45-2241
Email:
city INVER GROVE HIGTS
TYPE OF WORK _ Newreplacement Repair _ Rebuild Modify Space Work in.R.O.W.
Demi Bon o work::.
RESIDENTIAL
Water Heater
Lawn irrigation L_ RPZ / _ PVB)
_: Septic System
-__ New
_ Abandonment
PERMIT TYPE
?later Softener
Add Plumbing Flxtures (_ Main / _ Lower Level)
Water Tumaround
RESIDENTIAL FEES:
$55.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$35.00 Lawn Irrigation (includes $5.00 State Surcharge)
$55.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
'Water Turnaround (add $166.00 if a 5/8" meter is required)
$105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
$95.00 Fire Repair (replace bumed out appliances, ductwork, etc.) (includes $5.00 State Surcharge)
TOTAL FEES $
CALL BEFORE YOU DIG. Cali Gopher State One Call at (651) 454-0002 for protection against underground utility damage.
Cali 48 hours before you intend to dig to receive locates of underground utilities. www.gooherstateonecaliorg
I hereby acknowledge that this information is complete and accurate; that the work will be in conf
Eagan; that I understand this is not a permit, but only an application for a permit, and work I
accordance with the approved plana in the case of work which requires a,review and approve of
Print ,, nI /,1d-
Applicantsted Name
ance with the ordinances and codes of the City of
t to rt without a permit; that the work will be in
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA112607
Date Issued:08/20/2013
Permit Category:ePermit
Site Address: 1410 Rocky Lane
Lot:8 Block: 4 Addition: Cutters Ridge 1st
PID:10-19100-04-080
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Ashley Orman
130 Plymouth Ave N
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
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 -
Brian D Walker
1410 Rocky Lane
Eagan MN 55122
(651) 687-9838
Standard Heating & Air Conditioning
130 Plymouth Ave. N
Minneapolis MN 55411
(612) 824-2656
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA116909
Date Issued:10/14/2013
Permit Category:ePermit
Site Address: 1410 Rocky Lane
Lot:8 Block: 4 Addition: Cutters Ridge 1st
PID:10-19100-04-080
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 .
Natalie Velez
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 -
Brian D Walker
1410 Rocky Lane
Eagan MN 55122
Great Northern Builders
9419 Buckley Ct
Inver Grove Heights MN 55077
(651) 436-5672
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA143856
Date Issued:06/29/2017
Permit Category:ePermit
Site Address: 1410 Rocky Lane
Lot:8 Block: 4 Addition: Cutters Ridge 1st
PID:10-19100-04-080
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.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
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 -
Brian D Walker
1410 Rocky Lane
Eagan MN 55122
(651) 233-3839
Appliance Connections Inc
12850 Chestnut Blvd
Shakopee MN 55379
(952) 445-4803
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA168297
Date Issued:04/16/2021
Permit Category:ePermit
Site Address: 1410 Rocky Lane
Lot:8 Block: 4 Addition: Cutters Ridge 1st
PID:10-19100-04-080
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site. We encourage you to retain an electronic copy of
photos until the project passes a final inspection.
*Roof permits issued between December and March will be inspected in the spring or when weather warms up.
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 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 -
Michael & Elizabeth Forshee
1410 Rocky Ln
Eagan MN 55122
(651) 335-6241
Legacy Restoration Llc
15350 25th Ave N, Suite 114
Plymouth MN 55447
(763) 354-7660
Applicant/Permitee: Signature Issued By: Signature