4362 Sandstone Dr O,~ . ~i
T.
rP.t•f~L~i(yLG CONSTRUCTION COMPANY
GARAGES • ADDITIONS • BREEZEWAYS
Guaranteed Satisfaction - Full Insurance • Telephone 935-9103
• 6911 Meadowbrook Blvd.
J, ) • Minneapolis, Minn.
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CITY OF EAGAN Remarks * Cedar Grove Acquisition
~~4ddition ~~R G~~ #4 ~ot - 8 - R~k 3 pa~~~ 10 16703 080 03
Owner/"}'~/:'-~:'?~,~~•~Street 4362 Sandstone D~ ~ 5tate ~g~~ ~ 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF, c i9$5 1266
STREET RESTOR.
GRADING
SAN SEW TRUNK
* SEWER LATERAL ~y 19~I2 ],~304.00 rj2.jG Z$ P~~C~
WATERMAIN
WATER LATERAL ~.972
WATER AREA
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
INSPECTI4N RECORD
,~~i r ~ r~ s r~~~
CITY OF EAGAN PERMIT TYPE: 1 p ~
3830 Pilot Knob Road Permit Number: l~~~ ~,y
Eagan, Minnesota 55122-1897 ~2Q Date Issued:
(612) 681-4675 CJ (
SITE ADDRESS: i~~ ~ APPLICANT:
I,,. • r;r~~i~, fON~ Uir r~~~i. I li 1 r~tJN i11 c~ ~ ~~~~1. CNf;
~.I Ii/il~ ~,;.~~'~1 ~11li ~+.1. ) •'Nf~ '.4!I'~
PERMI~ ~S~ur~T1l~P~' TYPE OF WORK: f, i r F~ a i! r~ ~
, , ~ ~ i ~ ; ,
. .
t~~~+~~~11 t ti 3 I rJr,i
~ ~
~ ~
Permit No. Pertnit Nolder Date Telephona 11
ELECTRIC
PLUMBING
HVAC
Inspection Uete Insp. Commenis
FOOTiNGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE ~
FIREPLACE 3~ f~4
AIR TEST o~
FINAL PLBC~
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
- - - ~ - . t't~v~ •/zz.i ~T.r ~ l~Il3T7'~'1~Y1~C7 ~/~W~1E~Z
o : i ~l~!~ ~-r-p c.~-~ r-~z. ~?r,r+~a~ ~t~.
~
E 1--- ~ - - - - -
3 0 4~ 1 L~ ~ OFFI;~E ~O+NLY This request void 18 monMs from volidotion dote pnnted in this bayy
~~~/P /tlOY
~LEASE PRINT OR TYPE ~ " ~
el fa Rough-in inspetlion requiredt ? Yes - No Inspenion OtherThan Raogh-Irc 0 keady Now 0 Will Coll
~r ~'/oo must mll ~he inspeao~ when ready~ Daie Ready:
licensed wnhaROr Q owner hereby requesl inspedion of Ihe above eledricol work at:
ob Pd s(Street, Bw, or Raore No.) Ciry Zip Code
~OZ `.a4~iP/ /1 ~1 ZZ
ecAan No. Township Name or No. Range No. Fire No. Coun ^
hp~N
x~C P f ? ~
o r5 p,•y' er Address
~
/ - ~
lechi I onlmcbr Comp~ny Nomel ~ CoAnirad Lice s~~ Masrer Lic. Nn ~Plam Eleci. Only)
~tV / ~ l~
Aailing d s(Contmcmror r Pe ' g Inslollaf ~
- x sZx~c~~ , n :~'~sd
wMo' 'gnoNm( ritmdororOwnerP InsMllofion~ P(M,~re/No. J
/ ~l~
3 6/95 STATE DCOPY-SEEINSTRUCTIONSONBACKOFYELLOWCOPY
I~II (IIIII I II (I II ( I I~I I I II REQUEST FOR ELECTRICAL IN5PECTION~~
MinnesoW State Board of Electricity
1821 University Ave., Rm. S 128, f. Paul, MN 55104 j~~
s 0 3 0 4 7 2 1 4~ Phone (612) R^~. uaoo /9 y'(P
Home Duplex Apt.8ldg. Ofher: IJew Addn
Cammercial Indushial Farm Remad Re air
Air Cond. Hig. Equip. Wafer Hfc Load Mgmt. Other:
D er Ron e Elec. Hent Tem .$ervice
"k' q{~ove the work mvered by this request. Enfer remarks in this space and on }he back of !he white copy only.
/[J~~'t~+2T~2.~vi
. /Q4~SP'~~~l.Sll~ ~
~ ~2~Zaz`~P.- • '~y/^~'
Cal<ulole Inspection Fee - 7his Inspec~ion Requesl will noi be occepted without the mrrec~ ~
Oll~er Fee # $ervice Enharce Sae Fee Circui~/Feeders Fee
Mo6ile Hame Park Stall 0 to 200 Amps 0 to 100 Amps
5treet Ltg./~raffic Sig. Above 200 Amps 0 Amps
Tmnsformer/Generafor INSPECTOR'SUSEONLY ~ T L ~
Sign/Oulline Ltg. Xfmr.
Alarm/Remote Conhol -
$Wimmin9 Poo~ I hereb cem thor I ins e tfin ekckim ' Fn descnbed herein on Me does smted
Ircigation Boom pa~gh-In . Dote
Special (nspection
Finol Date,
InveSfigafive Fee
THIS INSTALLATION MAY BE ORDERED UISCDN ECTED IF NOT~COMPLETED WITHIN 18 MO IiS.
~ ~ ~
Clty of ~a~a~ ~ Pe~,~t# ~ a;
~
~ Permit Fee: ~ ~ YC~ I
3830 Pilot Kno6 Road ~ ~
Eagan MN 55122 j Date Received: j
Phone: (651) 675-5675 i star+: i
Fax:(651)675-5694 ~ ~
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Daie: ° ° Site Address: "f l ~ a~r.m~ st~~ne ~r
Tenant: Suite
RESIDENT/OWNER Name:q OIIC~ I~S-p,Q~~_~~. Phone:~~~°:J_71,/°J~L03
Address / City / Zip: 1 I l~ i ~u f LL/~1 V e~
Applicant is: _ Owner ~ Contractor
TYPE OF WORK Description of work: ~ e 0
ConstructionCost:cil~~.~'1~790 _ Multi-FamilyBuilding:(Yes_/No_)
CONTRACTOR Name: MQ~]~I-C'~r~;'T~ ~~rll7{-c~License#:~~,~i~a~a~
Address: ~
City: State: Zip:
Phone~ U1c~ ° a~ 1 c '~l
Lontact Person: ~
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NE BUILDING
Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672
Energy Code . Residential Ventila~ion Category 1 Worksheet • New Energy Code Worksheet
Category Submitted Su6mitted
submission typej • Energy Envelope Calculations Submitted
In the last 72 months, has the City of Eagen issued a permit for a similar plan based on a masier plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
~ L, ~~fi tA~OCi{~fl~& 1~18~' ~i! ~l~'~111H=-CflASI ~ ~ . ~l~C~J~~f~~ D,~"s~
~'`~aj~'~`t A~{~ .~,8~{,~'~'1~L~~'d~~~€~i
~-1'fETI{*'~' fl~~'~'k ~ }{t
E~~~~,~ 1 r Wi)U~~B" f~ #RJ~- :_,ti:
~W ~l~ ' [ {i~di~~~~ ~ ~;T`~z~~ ~ _ ~ "'~t~ t.~"_'
~us i ,t i a . ux= PC d .i I~.~ , i ...~~.a ...,:w~.-
I hereby acknowledge ihat ihis infortnation is complete and accurate; that the wodc will be in contormance with the ordinances and codes of [he Clly ot
Eagan; Ihat 1 undersland this is not a permit, but only an application for a pertnit, and work is not to start without a permit; Ihat the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
X i ~ x~~~~~~
~~.nc~
ApplicanYs Pr ted Name Applicani's Sign ture
Page 1 ot 3
2004 RESIDENTIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122 ~~7
~5~,~ ~ Telephone # 651-675-5675
Please complete for: single family dwellings & townhomes/condos when permits are required for each unit
Date~7
Site Address T 3~ 02 ,~C{,f~(i'~~~W~ ~I-i~/`e~ Unit #
Property Owner ~ ~l.t~ ~ Telephone # ( ~ ) ~ y 3 ~ 3
/ -
Contractor ~,h
~
r E~l~(/L( . '
StreetAddress ~~p c S"~ C-r- S~-eJa~ C~4' ~~,4~~
State ''"l 1V Zip ~a~~ Telephone # ( ) p~-~`
Bond Expires:
The Applicant is _ Owner ~Contractor _ Other
Add-on or alteration to existing dwelling unit $ 30.00
~ furnace _Additional ~[Replacement
air exchanger
airconditioner _New _Replacement
other
State Surcharge $ 'S0
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 tlus is not a
permit, but only an application for a permit, and work is not to start without a pernut; that the work will be in accordance with the
approved plan in the case of work which requires a review and approval of plans.
~
~~~J
ApplicanYs Pnnt Name p~i Ys ignatur
JUL 1 9 2004
By
2004 COMMERCIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Pleese complete for: commercial/industrial buildings
multi-family 6uildings when sepazate permits are not required for each dwelling unit
Date / /
Site Street Address Unit #
Tenant Name (if applicable) Previous Tenant Name
Property Owner Telephone # ( }
Contractor
Sheet Address City
State Zip Telephone # ( )
Bond Ezpires:
The Applicant is _ Owner _ Contractor _ Other
Work Type
New Construction _ Underground Tank _ Install _Remove ""see be/ow
Interior Improvement _ Install Piping _Processed _Gas
Nature of Work:
"•When insta!ling/removing underground tank, cap for inspection by Fire Marshal and Plumbing Inspector
PeTIll1~ FE¢S: $7050 Underground ffink installa[ion/removal
$50.50 Minimum (includes State Sumharge)
or
Contract Value $ x 1% Pemut Fee
• If pernrit fee is $1,000 or less, add $.50 ~ $ State Surchazge
If permit fee is over $1,000, add $.50 for
every $1,000 pernut fee $ Total Fee
I hereby apply for a Commercial Mechanical Permit and aclaowledge that the information is comple[e and accurate; tltat the work
will be in conformance wiih the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is
not a pe[mit, but only an applicafion for a permit, and work is not to start without a pernut; that the work will be in accordance with
the approved plan in the case of work which requues a review and approval of plans.
ApplicanYs Printed Name ApplicanPs Signature
Approved By: ,Inspector Date:
EAGAIeI TOVO/N S H I P ~0 7s2
BUItDING PERMIT
~ Ownez . ~ry . ~ . ~ Eagan Township .
Addrese (presen2) _..~........~..._ij~L'~~-.-f/Ilfira-.%7.~,- . . ~ Town HaIT ~ ~ ~ '
~ 8uilder /
~ ~ ~ . ~ ~ , ' Dafe .C..' / ~ -..~_3.-.._......__.....
Addiess ~ ~ . .
~ ~ ~ ~ - DESCRIPTION ~ ~
' Sfories To Be Used For ~ Froni ~ Depih Heigh! Esf. Cos! Permif Fee ~ Remarks ~
. ~ . . ~ L~iL"'_`."'%f_. . ~(y/ ~ . , /-n ~ . ~ .
!c
~ ~ - ~ ~ ~ . LOCATION - ~ ' ~ ~
Sfreel, Road or oiher ~ Desar_piion of ~Location ~ ~ Lo ck . Addifion or Traci
-
7,~- S ~
f~ ~ a ~ # ~
This permii - does~ noi auihorize 1he use of sixeels, roads. alleys or sidawalks nor does if give !he owner or his ageni
ihe righf !o create anp sifuation which is a nuisanee or which presenfs a hazard fo ihe healYh, safeiy, convenience and
general welfare lo enyone in ihe eommunity, _ ~
THIS PERMIT MUST BE /K~EP ON THE PR~/g~
M~ISE WHILE THE WORK IS IN PA'O/GAES .
This is to cerlify, thaf_...L``-'-~-:...~~-:-,'t'~------..........has permission !o erecf a~_...~~~~.......__......upon
!he above descri ,pre ' subjec! io~lhe~J is~ons of fhe Building Ordinance for Eagaa Township dop4ed April II,
. 1955. ~ . ~ _ _ : . , ~jJ /p .
" ..._"'-....-------~~7!'?~_.`...----. . Per _Q~.~ C'-~~....
. . . - -
. - . Chairman of Tnwn Baard ~ . . Building Inspeafor~ ~
PERMIT ~ ~05~~90
~ CITY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: B u I ~ o i N s
Eagan, Minnesota 55122-1897 Permit Number: 0 2 7101
(612) 681-4675 Date Issued: 0 3/ 0 5/ 9 6
SITE ADDRESS:
4362 SANDSTONE DR
LOT: 8 BLOCK: 3
CEDAR GROVE 4TH
P.I.N.: 10-16703-080-03
DESCRIPTION:
r--~ {GAS}
"~BuiTtling Permit 7ype FIREPLACE
euildi~Cj Work Type ALTERATSON
f,~=~ ; ~ensu<~ ~0~1-:~, 434 ALT. RESIpENTZAL
~
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%.s, ~ , e-~' ~
,.~'%<:.'~...s~P~r~ir. ..a ~~e
1'~~j_5
V { ~ ~ ~
~ ,yi"e'l ~`t ,
~
~f I l ,1 y t r'
~
/f_'-~~,-_ " 7 _ _ '~m i.: ~ =~:_t~1 + , . ;r
4 ~-.v~~~~ - '
REMARKS:
FEE SUMMARY:
Base Fee $25.00
Surcharge $.50
7ota1 Fee $25.50
CONTRACTOR: - Applicant - OWNER:
NORTHTOWN HT6 & COOLING 17805015 LANG MIKE
15759 pIERCE ST NE 4362 SANDSTONE DR
HAM LAKE MN 55434 EFlGAN MN 55121
(612) 780-5015 (612)454-7986
T her^eby ackno+.!ledge that I have read this a:pplicaC3on and state that Che
infiormat~on i=s .carreat and agree to comply with all applicable State of Mn.
StaLutes and City ofi Eagan Qrdinance,s.
_ _ . _ _ _ ~
A~ A~ ITEE SIG TURE ~IS~:~IGN /R~ ~
l
' CITY OF EAGAN ~'~j'
~ 3830 PILOT KNOB RD - 55122
~I ~ 7996 FIREPLACE PERMIT APPLICATION
~
681-4675
DATE: ~ ~ ~ -
DESCRIPTION OF WORK: _ INSTALL ~~p( FIREPLACE: _ WOQD BURNING GAS
_ INSTALL GAS LOG ONLY IN EXISTING FIREPLACE
_ INSTALL GAS LINE ONLY IN EXISTING FIREPLACE
OTHER:
AREA TO BE INSTALLED IN: t Y + ~ 2~~-~--, ' =-z
,
~ . p~
STREET ADDRESS: `7 • ~ ~ ~~z~-•C=:~-e=~~.-- -r-~z -
LOT Y~ BLOCK SUBD./P.I.D.#:
APPUCANT: (circle one only) OWNER ~CONTRACTOR~~
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.
PROPERTY Name:~c~1~.-, ~ir.%~< Phone 7~~~
OWNER -7,~` ^A,•
Signature:
~
Street Address~ y > G ~
City: ~ State: ~zz, Zip: ~ ~
FIREPLACE Company:~L ~ r- ~c_ Phone l7~ S`: l~'
INSTALLER
Signature: ~
Street Address: /S %S~ j,ce2-c~ ~ f lL%i
~ License
Ciry:~~.-~,.. State: ` Zyt Zip~ ss``05 y
~
GAS LINE Company: -~d-z~..~ Phone
INSTALLER
Name:
Signature:
Street Address~
City: State: Zip:
.
OFFICE USE ONLY
BUILDING PERMIT TYPE
0 14 Fireplace
WORK TYPE
? 31 New o 33 Aiterations
0 32 Addition o 34 Repair
GENERAL INFORMATION
Census Code.
SAC Code
REMARKS: Chimneylflue must be inspected before concealing.
FEES
Permit Fee
Surcharge
Other
Copies
Total:
v ~ EAGAN TOWNSI-IIP
N° 13'71
BUILDING PERMIT
Owner '----!•~.R~-"-`-'"-~---' -----_x~.-°~~f-I----"-- Eagan Township
Address (preseni) z. . ..~°..`."v Town Hall
Suildes .-----~.^:~e!R.^.--=`..'..~~---..L~...°.x~.:..---"~-~---- ~
Dafe __~~~l.9~~s.f.J....---°--.-.----
Address
DESCRIPTION
SSosiea To Bo Used Fos Fxoni Depih Heighf Esi. Cosi Pexmif Fee Aemazkc
. °'`o °z ~f /~''So 7 ~ ~ ,P-~-~-<e.
LOCATION y° /9 Gy
Sfreel, Aoad or oiher Descripfion o£ Location I Lo! Block Addition or Traei
~ 3 ~ ~ ~
This permi! does not aulhorise the use of afreefs, roads, alleps or sidewalks nor does i3 give ihe owner or his ageni
!he righi io ~reaie aap silualion which is a nuisance or which presenffi a hazard !o !he heallh, safefp, convenience and
general welfare 2o anyone in !he eommunilq.
THIS PERMIT MUST BE KEPT,ON THE PngEMISE WHILE TFIE WORK IS IN PROGAESS.
This is !o eerlify, fhai~~.r.:~!"^"~.--.-S:.f~-~:-_...._haspermission !o ezec! a_--------_~.--. upoa
.
!he abave described psemise subjec! !0 2he psovisions of !he Building Ordiaanee for Eagan Tow ship opled April 11,
1955. //{7 p~
_
: ~
_....._""-"'-.......(t.Lt1~-'---'~L.a..----.. Per - ' - ~~.-r.^..:.~:~rS.z.'-'_'...._""'-"""•--".....
Cheirman of T~wn Board Building Inspector
c, _ /S-
~ CLAIM VOUCHER - REFUND REGIUEST
CITY OF EAGAN
MAKE CHECK PAYABLE TO : FI?tESIDE CORNER INC
ADDRESS : 2700 N FAIKVIEW AVE
ROSEVILLE MN 55113
=o~~evav=~_~~ee=ve'=v~_e==v~_v~__ee-~-~---ee~~~a~~_e~~=v=oa~~~e~v_e~_~ee
LOCATION 4362 SANDSTONE DB - ~n. Y"
RECEIPT DATE CR 52633 /.7AlatipRY 1. 1996 .
REASON FOR REFUND ANOTHER CONTRACTOB WAS GIVEN THE JOB
TYPE OF REFUND ELECTRICAL PERMIT 3211-9001 $
PLUMBING PERMIT 3212-9001 $
MECHANICAL PERMIT 3213-9001 $
SURCHARGE 2155-9001 $
WATER CONNECTION PERMIT 8713-9220 $
SEWER CONNECTION PERMIT 3743-9220 $
ACCOUNT DEPOSIT 2252-9220 $
UTILITYACCTOVER-PAYMENT 2250-9220 $
CURB BOX DEPOSIT REFUND 2253-9220 $
CONSTRUCTION METER DEP REFUND 2254-9220 $
WATER USAGE CHARGE 3711-9220 $
OTHER: xnrr.nrxr. PF.RMTT 3210-Q001 $ ~s.nn
$ I
$
I declare under the penalties of law that this account, claim or demand is just and
that no part of it has been paid.
II~,{aiU~~lA1t1,,.=JiCu.~A t,1S77.~ 03/26/G6
Signa re 3~. y~ Date
~~~f ~
PERMIT
+ CITY•OF EAGAN
3d30PilotKnobRoad PERMITTYPE: Buz~oiN~
Eagan, Minnesota 55122-1897 Permit Nu mber: 0 2 7 0 0 0
(612) 681-4675 Date Issued: g~. / 31 / 9 6
SITE ADDRESS:
4362 SANOSTONE OR
LOT: 8 BLOCK: 3
CEDAR GROVE 4TH
P.I.N.: 10-16703-080-03
DESCRIPTION:
'y` (GAS)
6`uii ng~Permit Type FIREPLACE
~tuil ing ~~Wayc1S, Type ALTERATION
Cen us Code , 434 ALT. RESIDEN7IAL
~ ;
,
i
, -
~
_
~ ''s ~ 1 +~-t ~t'g~ .i i~~1
/ . . ' ? , . _ .
:...-~wv _ _ . _
REMARKS:
r
FEE SUMMARY:
Base Fee $25.00
Surcharge $.50
Total Fee $25.50
CONTRACTOR: - Applicant - sT. I.IC OWNER:
FIRESIDE CDRNER INC 16331042 0601068 LANG MIKE
2700 N FAIRVIEW AVE 4362 SANDSTONE DR
ROSEVILLE MN 55113 EAGAN MN 55122
(612) 633-1042 (612)A54-7986
I hereby ecknowledge that I have read this applicatian and state that the
information is correct and agree to comply wiCh all applicable State ofi Mn.
~ StatuCes and City af Eagan Ordinances. ~
~ ~ou.0 R~~~Q.I
~ 1fIVT/PERMITEE SIGNATURE ISSUED BY: IGIJA~tlRT~
~ . ` CITY OF EAGAN ~ ~
~D
~ 3830 PILOT KNOB RD - 55122
1996 FIREPLACE PERMIT APPLICATION
681-4675
DATE: C ~
DESCRIPTION OF WORK: Ci INSTALL FIREPLACE: _ WOOD BURNING ~ GAS
_ INSTALL GAS LOG ONLY IN EXISTING FIREPLACE
_ INSTALL GAS LINE ONLY IN EXISTING FIREPLACE
OTHER:
AREA TO BE INSTALLED IN: -Ex~ ~7/~~ ~-1.YL-~Y`~~1 C-~
STREET ADDRESS: ~3 ~ 2- ~ ~z~y ~ ~~Z
LOT ~ BLOCK ~ SUBD./P.I.D. ~~~~417~- li-~l-
APPLICANT: (circle one only) OWNER CONTRACTOR
i hereby acknowledge that I have read this application and state that the information is correct and agree to
comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
PROPERTY Name:V •~//L ~~A ~L~ A ~ Phone ¢ - 798 ~
OWNER
Signature:
Street Address~~~ ~Z S~ns~a~l~r ~
City: ~ A t~ State: Zip; ~3~/ 2 Z_
FIREPLACE Company~l-i .O~ - alCa~W~2 Phone 633 ~ Lb'"6 /
INSTALLER
Signature:
Street Address: Z 700 ~ro,
r~2?/c~ License 6$
CityllL~c~VI 1,~~ State: Zip~ ~`~5~~3
GAS LINE Company: Phone
INSTALLER
Name:
Signature:
Street Address•
City: State: Zip:
~
w .
OFFICE USE ONLY '
BUILDING PERMIT TYPE
0 14 Fireplace
WORK TYPE
0 31 New o 33 Alterations
0 32 Addition ? 34 Repair
GENERAL INFORMATION
Census Code.
SAC Code
REMARKS: Chimney/flue must be inspected before concealing.
FEES
Permit Fee
Surcharge
Other
Copies
Total: