2103 Shale LaneCITY OF EAGAN Remarks * Cedar Grove Acquisition
Addition CMAR GR= #4 Lot $ elk $ Parcel 10 16703 080 0$
Owner Street 2103 Shale Lane State Eagan, MN 55122
-
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK
* SEWER LATERAL 1972 1,304.00 52.16 25
WATERMAIN
* WATER LATERAL 1972
WATER AREA
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
EAGAN TOWNSHIP
Owner
BUILDING PERMIT
------------------------------
(present) .Z..... '4*._.. .............................
N° 1246
Eagan Township
Town Hall
Date `r
................................
treat, Road or other Description o:
v( ;2 3B4 I?Jf 564 .7,s
/S?•? I G of rr0
LOCATION
?'. -b . ,ee ht
This permit does not authorise the use of streets, roads, alleys or sidewalks nor does it give the owner or his agent
the rig to create any situation which is a nuisance or which presents a hazard to the health, safely, 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 permission to erect a.hz .----` ......... ........... -_
upon
the above described premise subject to the provisions of the Building Ordinance for EaganUl'ownship adopt t Ad April 11,
1955. _ ..............................U"?.lY?t.. " ................... Per ------------- r.[......
Chairrhan of Tnwn Boarll
? Building Inspector
or
EAGAN TOWNSHIP
BUILDING PERMIT
Owner ...... ' - . '?IJa t c? ? C ..............
Address (present) .../..G.3....-----.---
Builder ._ .......... .... ... .............._...--_....`-.......---.-.....---.......---._-
Address .------...----°"'-...--......'--""......................................... ........
DESCRIPTION
N° 1339
Eagan Township
Town Hall
Dale -_a!-L. /-.G-r . . ....................
Stories To Be Used For Front Depth Height Est. Cost Permit Fee Remarks
_
U LOCATION
Street, Road or other Description of Location Lot Block Addition or Tract
' IS ?/-,) 7c`?'4
This permit does not authorise the use of streets, roads, alleys or sidewalks nor does it give the owner or his agent
the right to create any situation which is a nuisance or which presents a hazard to the health, safety, convenience and
general welfare to anyone in the community.
THIS PERMIT MUST BE Kf;PT ON T E PREMISE WHILE THE WORK IS IN PROGRESS.
This is to certify, that ..... ........ ......... has permission to erect a.............. •---'.......... .... • • - ......upon
the above described premise subject to the provisions of the Building Ordinance for Ea A Towns p adopted April 11,
1955. ?J? /? ? p / ? ,, B L
_ ..................................._Q--.. Per -------------------- --....... u......li--.'..;?":--.s.--...
Chairman of Tnwn Board. d / Buildin Ins ector
PAID Pfll,Y 0 3 20GZ
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
l1 3830 PILOT KNOB RD - 55122 S -
651-681.4675
New Construction Reguiremerds
3 registered site surveys showing sq. R of K sq. R of house; and as 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 g lot platted after VIM
Rim Joist Detail Options selection sheet (bldgs with 3 or less units)
DATE x:41 ?
JOB SITE ADDRE!
IF MULTI-FAMILY
PROPERTY OWNI
TYPE OF WORK_
APPLICANT
ADDRESS MM/
PAGER #
S
RemodelfReoair 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 Z 7,087 • °o
HOW ly1ANY UNITS?
.n n e I-- r
CELL PHONE #
'LACE(S) _ 0 _ 1 _ 2
PHONE# '16-4- 9,35- *q
0
ff_ZIPCODE 653"/3 (/
FAx # 9507 • g35' g'?'A
NEW RESIDENTIAL BUILDING ONLY - FILL OUT COM
Energy Code Category
(check one)
Plumbing Contractor. _
Plumbing System Includes:
Mechanical Contractor. _
Mechanical System Includes.-
Sewer/Water Contractor.
Phone #
Phone #
Fee: $70.00
All above information must be submitted prior to processing of application.
I hereby acknowledge that] 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 Ordinanc
Signature of Applicant
Certificates of Survey Received _ Tree Preservation Plan Received _ Not equired _
Updated 2002
MINNESOTA RULES 7670 CATEGORY I
- Residential Ventilation Category 1 Worksheet Sut
- Energy Envelope Calculations Submitted
MINNESOTA RULES 7672
- New Energy Code Worksheet Submitted
Phone #:
Water Softener _ Lawn Sprinkler
Water Heater _ No. of R.I. Baths
No. of Baths
- Air Conditioning
- Heat Recovery System
YgR0T?-
MAY 0 6 2002
Fee: $90.00
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.) ? 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)
Footings (addition)
Foundation
Drain Tile
Roof _ Ice & Water _ Final .
Framing
Fireplace _ R.I. Air Test _ Final
Insulation
_ Final/No C.O.
_ Plumbing
HVAC
_ Other
Pool _ Ftgs _ Air/Gas Tests _ Final
Siding _ Stucco _ Stone
Windows (new/replacement)
Approved By Building Inspector
Base Fee /53 25 ^? __
Surcharge y -
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total 15'7. ZT
Cities Dili
ity Control
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Every effort was made to capture the content
from the original page.
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g2a) RESIDENTIAL BUILDING
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction Requirements RemodeVReaair Requirements Office Use Only
3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 copies of plan _ Ced of Survey Recd
(20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions _ Tree Pres Plan Recd
2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks _ Tree Pres Not Reqd
l set of Energy Calculations Addmon - mdicate if on-site septic system -On-site Septic System
3 copies of Tree Preservation Plan if lot platted after 711/93
Rim Joist Detail Options selection sheet (bldgs with 3 or less units
R/
Date ? Construction Cost
Site Ad ens ?
n ¢(? 'S ? '
4i A Cd A?LQ_i Unit/Ste #
/
Description of Work 4 J P 1i
Multi Family Bldg YN
- Fireplace(s) 0 - 1 - 2
Property Owner ' /
c Z i i L, Telephone # ()S c sli
p
Contractor
Address ity
State eph )
TP /)V
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Category I _ Minnesota Rules 7672
Energy Code Category • Residential ventilation Category 1 Worksheet New Energy Code Worksheet
(J submission type) Submitted Submitted
• Energy Envelope Calculations Submitted
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
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 pent, and work is not to start without a
permit; that the work will be in accordance with the approved plan in t case f work ich requires a review and
approval of plans. , -
i
Applicant's Printed Name A licant's %nat re
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.)
?. 03 01 of_ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.)
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo)
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
Work Types
? 30 Accessory Bldg
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi Misc.
? 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) - 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
- Footings (new bldg)
- Footings (deck)
- Footings (addition)
_ Foundation
_ Drain Tile
Roof _ Ice & Water _ Final
Framing
Fireplace - R.I. _ Air Test _ Final
Insulation
REQUIRED INSPECTIONS
Final/C.O.
_ Final/No C.O.
Plumbing
_ HVAC
Other
Pool _ Ftgs _ Air/Gas Tests _ Final
Siding _ Stucco _ Stone
- Windows (new/replacement)
- Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
Building Inspector
I 31 oa, I \5:sb
2006 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
Date 0 4 1!5 0 6 l
WALDOWSKI, ROBERT
Site Street Address 2103 SHALE LANE Unit #
• EAGAN, MN 55122
(651) 454-2590
Property Owner Telephone #
( )
Contractor N0rblaYn Pui-mole Telephone# (IoIZ-) g27-y0?3
Address 2-gD5 ejo r-f lqd 1y. Std, city Yeats State (u zip1?-9409
The Applicant is: _ Owner Contractor -Other
Septic System - New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee
$ 100.00
Per as-built $ 10.00
Alterations to existing dwelling $ 50.00
_ Add plumbing fixtures. This fee includes installation of a water softener and/or water
heater at the same time. If you are installing only a water softener and/or water
heater, do not complete this section; move to the next section and check the
appliance(s) you are installing.
-Septic System Abandonment
-Water Turnaround (add $130.00 if a 5/8" meter is required)
Other:
/
_ Water Softener _
Water Heater $ 15.00
new replacement
Lawn Irrigation _RPZ _PVB -new -repair -rebuild $ 30.00
State Surcharge $ .50
Total $ •5?
I hereby apply for a Residential Plumbing 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 plumbing codes; that i
understand this is not a permit, but only an application for a permit, work is n t s rt without a permit and work will be in
accordance with the approved plan in the event a plan is required to Vr dap oved.
Je?rel4 i,. Mort loryL
Applicant's Prin d Name Applican' ignature
J?, at5
°7b .10
2006 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New construction Reautremenis Remode[Repair Reouirenrim Office Use Only
3 registered site surveys showing sq. R. of lot, sq. ft. of house; and all roofed areas 2 copies of plan showing footings, beams, joists Carl of Survey Recd , ._ Y -_ N
(20%maximum lot coverage allowed) 1 set of Energy calculations; for heated addition TreePres Plan Recd -Y _ N-
2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks Tree?Pres Required Y. _ N
1 set of Energy Calculations Addition - indcate it on-site septic system On-site Septic System _Y _ N
3 copies of Tree Preservation Plan it lot platted after 71153
Rim Joist Detail options selection sheet (buildings with 3 or less units)
Minnegasco mechanical ventilation form DEC 1 42fif1i
Date Construction Cost
Site Address ??(f ?2'?'-/`?GF G?,4iY'f? Unit/Ste #
Description of Work [ ?!ti
Multi-Family Bldg _ Y /4 N Fireplace(s) _ 0 - 1 - 2
Property Owner X77 (/ fi- 1?????GG2i?A5 / Telephone#(?JX
Contractor i
Address City
State Zip?? ad Telephone #
7 i
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 - Minnesota Rules 7672
Energy Code Category • Residential Ventilation Category 1 Worksheet New Energy Code Worksheet
(V 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 #(
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 se of work which requires a review and
approval of plans.
%?6e 4r (?tr? ?? o r.L-,s kf`
Applicant's Printed Name Applicant's i ature
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 ? 18 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- lex? 25 Miscellaneous
Work Types "? Js F•f:}
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
?K 33 Alteratio ? 37 Demolish Building* ? 43 Reroof ? 46 Windows/Doors
34 Replacement *Demolition (Entire Bldg) - Give PCA handout to applicant
Description: Watfeer Dam ? a?ge / ? _ Yes
Valuation J Occupancy MCES System
Plan Review 100% or 25%
Census Code Zoning City Water
SAC Units Stories Boaster Pump
# of Units Sq. Ft. PRV
# of Bldgs f? Length Fire Sprinklered
Type of Const V Width
REQUIRED INSPECTIONS
- Footings (new bldg) _ Sheetrock
_ Footings (deck) _ Final/C.O.
_ Footings (addition) x FinalNo C.O.
Foundation I
HVAC
_ Drain Tile Other
Roof _ Ice & Water _ Final
Ftgs _
Pool Air/Gas Tests _ Final
Framing _
_
_ Siding _ Stucco Lath _ Stone Lath -Brick
_ Fireplace - R.I. _ Air Test -Final _ Windows
Insulation Retaining Wall
Approved By:
- ------------ - -- -- Building Inspector
- -
-
--
-
------------------
---
-
Base Fee --°
----------------------------------------
-
-
--
--
-
Surcharge ) L
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Tota I
2006 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
Date I I 1 D IrD
Site Street Address ---?r o,3 cl r, Unit #
Property Owner a'? UPS ?? Telephone # ( )
2C.?
Contractor (/1
Telephone # ( )
-
`(
--rr
Address 7 aU rt, 0A_
? City ???t Jf 1+?r Stated ZipSML
The Applicant is: _ Owner Contractor -Other
Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license includes County fee
$ 100.00
Per as-built $ 10.00
yr?? 7? IL
Alterations to existing dwelling rv ?S'E ""` " \ ??? J $ 50.00
4 Add plumbing fixtures. This fee includes installation of a water softener and/or water
7
heater at the same time. If you are installing only a water softener and/or water
heater, do not complete this section; move to the next section and check the
appliance(s) you are installing.
-Septic System Abandonment
-Water Turnaround (add $130.00 if a 5/8" meter is required)
Other:
Water Softener _ Water Heater $ 15.00
- new _ replacement
Lawn Irrigation _RPZ _PVB -new -repair -rebuild $ 30.00
State Surcharge $ .50
Total 5 ?ro
$ 5 (J
I hereby apply for a Residential Plumbing 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 plumbing codes; that I
understand this is not a permit, but only an application for a permit, work is not to start without a permit and work will be in
accordance roved plan in the event a plan is required to eviewed and approved.
?UAvc
Applicant'8 Y76V J?,„ eC t Applicant>>sSignature
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 2103 Shale Lane
Lot: 8 Block: 8 Addition: Cedar Grove 4th
PID:10- 16703 - 080 -08
Use:
Description:
Sub Type: e- Reroof & Siding
Work Type: Reroof & Siding
Description:
Census Code: 434 - Occupancy:
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 6,000.00
Contractor:
Signature Home Services
758 Reaney Ave.
St. Paul MN 55106
(651) 731 -1147
PERMIT
City of Eaan
Reroof: If there is no ice protection inspection prior to final, you must meet inspector with ladder and flat bar.
Siding: When installing ventilated soffit material, remove existing material (ie: debris that could block vents) and take steps
to ensure maximum ventilation to attic. Call for final inspection after installation.
Marc Prasch
BL - Base Fee $6K
Surcharge - Based on Valuation $6K
Total:
Applicant/Permitee: Signature
- Applicant -
Construction Type:
$132.75
$3.00
$135.75
Owner:
Robert J Waldowski
2103 Shale Lane
Eagan MN 55122
Permit Type:
Permit Number:
Date Issued:
Permit Category:
0801
9001
Issued By: Signature
Building
EA086426
09/26/2008
ePermit
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply
of Minnesota Statutes and City of Eagan Ordinances.
h all applicable State
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 2103 Shale Lane
Lot: 8 Block: 8 Addition: Cedar Grove 4th
PID:10- 16703 - 080 -08
Use:
Description:
Sub Type: e- Windows/Doors
Work Type: Windows/Doors - New/Replacement
Description: House
Census Code: 434 -
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 3,000.00
Contractor:
Signature Home Services
758 Reaney Ave.
St. Paul MN 55106
(651) 731 -1147
PERMIT
City of Eaan
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
Applicant/Permitee: Signature
- Applicant -
Construction Type:
Occupancy:
Carbon monoxide detectors are required by law in ALL single family homes.
Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing
inspection. Call for final inspection after installation.
$88.50
$1.50
Total: $90.00
Owner:
Robert J Waldowski
2103 Shale Lane
Eagan MN 55122
Permit Type:
Permit Number:
Date Issued:
Permit Category:
0801
9001
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply
of Minnesota Statutes and City of Eagan Ordinances.
h all applicable State
Issued By: Signature
Building
EA088660
04/06/2009
ePermit
FIRE STOP SOFFITS AND ALL
OTHER DEAD SPACES.
7( ai5
A VAPOR BARRIER MUST BE
INSTALLED ON THE WARM SIDE OF
ALL WALLS AND ATTIC CEILING.
SMOKE DETECTORS ARE WIRED
ON EVERY LEVEL OF THE H USE AND IN
EVERY SLEEPING ROOM AND IN EVERY
HALLWAY LEADING TO A SI IrING ROOM
777
IL pi -72_
57<7
E ':GAN
,;.DNC INSPECT! a NS DIVISION
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA136723
Date Issued:05/26/2016
Permit Category:ePermit
Site Address: 2103 Shale Lane
Lot:8 Block: 8 Addition: Cedar Grove 4th
PID:10-16703-08-080
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.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
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 -
Robert J Waldowski
2103 Shale Lane
Eagan MN 55122
(651) 454-2590
Benjamin Franklin Plumbing
5718 International Parkway
New Hope MN 55428
(612) 238-9709
Applicant/Permitee: Signature Issued By: Signature