4457 Slater Rd --~,~t ~ f ^ ~
Receipt ; MECHANICAL PERMIT Parmit No.
C17Y OF EAGAN z t c c {
+ Fee ~
~ Fill !n numbered spaces S/C `
Type or Print /egib/y ~ ~ , : ,
Tot.
1. Date z- 2. Instaliation Cosi I
3. Job Address y~ Lot /(o Blk. ~ Tract ?`''i ; i
l--
~.e•~-a-c~,.•--~l.~-t ~
4. Owner ~ ;
f
~ c~ ~ ~ . , ~ I
5. Contractor ~ ~ i ~;f~^~- Phone ~
6. Address ~ , t'` ~ ' u'/'.~,,~ _^,.~,~~C i
I~
7. CitY State Zip 5'~`" i
8. Bui4ding Type: Residential ~ Commercial Q Institutionai C~
9. Work Description: New '~7 Add ? Alier ? Repair ? '
I
10. Describe Fuel Type ,TJ~ '~7~'' II
~I
11. No. Equioment HTU - M. Ea. No. Epuipment CFM '
~
Forced Air ° 1- Air Handling: ~I
Mfg. ,
Boilers Mech. Exhaust II
4dlfg. '
Unit Heater I
Mfg. Other ~i
Air Cond. ~ ~
Mfg.
Gas, Piping Outtets
12. I hereby certify that the above information is true and correct, and l agree to
comply with all ordinances and codes ~overning this type of work.
Signed: ~ ~ for
Rough ~inal
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Appro~ed CITY OF EAGAN 454-8700
~
~ , ~ _ K ~
Receipt . ' " PLUMBING PERMIT Permit No. ' ' '
CITY OF EAGAN ~ -
Fee
FiIJ in numbered spaces S/C
Type or Print /egib/y To~ ~
1. Date - 2. Installation Cost
" r ; l ,
J
3. Job Address ~ Lot~Q_Blk. z- Tract ~
~
- -
4. Owner
5. Contractor ~ R 1 ~ ~ Phone~ -
6. Address ` ~ ~ ~ "
7. City - ' State ZiP - ~
8. Building Type: Residential d•, Commercial ? Institutional O
9. Work Description: New Add O Alter O Repair ~
10. Describe ~
11. No. Fixtures No. Fixtures
~ Water Closet ~Sp~~(Drainfield
Bath tubs Septic Tank
Lavatory
Softner
Shower Wel I
' Kitchen Sink
Urinal/Bidet Other
~
" Laundry Tray
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. I hereby certify that the above information is true 9nd correct, and I agree to
comply with all ordinanc~s and codes governing this type of work.
Signed : for
Rough F inal
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
ar~r oF ~?c~?N ~
~ ~ =7!'i Pqef Kwob Reed E~yen, MM SS 122 '(1
PHOlIE: 454-8100 ' r ' ~ ~
BUILDING PERMIT Recefpt #t ( > %
To b~ rad for SF DWG/GAR Est, vafve $55, 000 pote _,Tulv 8 _~q $3
Sife Address 445T Slater Read Enct ~ Occuponcy R-3
Lor 6 elack 2 Sec/SubCinnamon Rid~e 3rd Alter p Zoni?,g (FD) R-1
parce~ # l n U4fi1 n60 02 Repoir ? Fire Zone NA
Enla~ ? Type of Const. v
eWC Nome ZBCt"lIDSA ~10~@$ . YIIC .
? # Stories
z ,~rc~ 7760 Mitchell Road
~ DemoHsh ? Length 42
G~den Prairie p~1O1e 937-9520 Grode p Depth 26 Sq. Ft.
~ i:evmen Comstruetion. Inc. Avworols Fee. ~
Name
/lddress ~952 FJoodland C1rCle Assessment Permit 298.00
Cit Mt};t;. 55343 pha~e 934-I218 Woter 8 5ew. Surchnrye ~ 27.50
~ Police Plan check ~ 0
~W Nome Firo SAC - 525.00
Erg. Wate~ Conn. 450 • 00
iW Ci PF~one Planne~ Woter Meter 60 • oQ
Courxil Rood Unit 250.00
I hereby acknowledge thot I have reod this'opplication ond state that Bldfl. Off.
the intormotion is correct ond ogree to comply with oll applicoble APC Total S1759.50
State of Minnewto Stotutes ond City of Eogon Ordinonces,
Signpture of Permittee
A Building Pem,ir Is issued ~o: Keymen Conetruction, Inc. on rhs e
xprost eonditioe~ thni
oll work shall be done in accordante wlth oll oppli~able State of Minnesota Statutes end City of Eapen Ordinanees.
Buildinp Offkiol ~
~
P~rmit No. Psrmit Holder Misc. Permit No. Holder
Plumbiny ~ ~ n Z-~ ~3
H.V.A.C. t 3 3 ~ ~ ~l q g~
W~II
Watsr
D'ap.
Sevwr
E~~ ~.osyS+~ G~o~e ~(fc. ~~~~!-~3
Inapection Dste Insp. Other
Footinpt - /
Found~tion
Framinp
Rouyh PIlq. ~
Rouph HVA
Inwl~tion
Fin~l PIb4
Finai HVAC ~ ~
FinN
W~r Describe Loestion:
1Nall
Stws?
P?. D'ap.
k
I
CASH RECEIPT
CITY 4F EAGAN.
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE 19
wRCUV~n
FwoM
AMOUNT ~ I
6 DOLLARS
~oo
~ CASH ? CHECK
row
FVNO GGDE aMOUNT .
Than You
~ BY
White-PaYers CoPY
v Yellow-Posting Copy
Pink-File Copy
CITY OF EAGAN Remarks
Addition CINNAMON RIDGE 3RD ADDN ~ot 6 R~k z Parcel 10-17402-060-02
Owne~ 5treet 4457 SLATER ROAD Scate EAGAN MN 55122'
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF. 1 1 ~12.2~ C009924 11-15-84
STREET RESTOR.
GRADING
SAN SEW TRUNK J 1973 102.22 6. 81 15 13.69 C009925 11-15-84
SEWERLATERAL 1985 724.53 144.91 5 724•5 C00992 1-15-
WATERMAIN
WATER LATERAL 19$5 61] . 3Q 123. ~F6 5 - -
WATER AREA 1973 131.44 8.76 15 17.5 C009925
Services x 1985 393.87 7$,77 5 393.87 C009924
STORM SEW TRK 1979 381.69 1~. 08 20 2 .13 C009925
STORM SEW LAT F 1985 1~98.83 219. 5 • C
CURB & GUTTER
SIDEWALK
STREET LIGHT
ROAD IT 250.00 36929 7-8-83
WATER CONN. 4SO.OO
BUILDING PER,
SAC n n
PARK
. . .r . :,~•yc~N..~r,~s•F .i ,
. , . . , 5 ~ ,r . .
' . 1 ' . ~ - - ' ' ~ } ' _
• ~ - ~ ~ -~~~.6 - ' 4" ~ .
CITY OF EAGAN WATER SERVICE PERMR
3$~0 Pilat iCnob Road
P. O. Box 21199 PERMIT NO.: 4931
Eagan, MN 55121 DATE: 7-29-83
Zoninp: RIV No. of Units: 1
p,~,r,er: Kevmen Construction
Addreas:
~/~rc~: 445~ Sla e~Road L.6 B2 Ginnamon Ridge III
~'~~,~r WEStOnka S F~ W
~ Met~r No.: (o S~/'1 ~8 ConnecNon Cha~e: 450.00 ~d
Size: ~ Account Deposit:
Raode IVo.: Q g~- lv 3(0 3 O Permit Fee. 10. 00 pd
1~yn~ te eeeolp wi11~ 1~ C1eq ei E~qa¦ Surchorge: • .50 Pd
p,~,,.u~, M~~ 60.00 pd mete
Totol:
By ' Date Paid:
~ate of Ir?sp.: Insp.:
CI i 1r UF EAGAN WATER SERVICE PERMIT
38:~0 Pilot Knob Road ;1
P, c~. Box 21199 PERMIT NO.:
Eagan, MN 55121 DATE: 7-44~~~
RIV No, of Units: 1
Zonlnp:
R er. Constructi.on
Addmss: 44 ~la oa~l L(, 1i^_ Ci~mamon i;i,'~e IZ1
Site /lddress:
Plurr~ber: ~ t~r. r a S ~ 1?
AAetsr No.: Ccnnection Charoe: G50.00 pd
Stze: A«aunt Depos7t: 10. UG ~•1
~~r Pem'~it Fee:
.SO pc'.
1 prN h oo~vh' wllii !IN Cie~r oi E~~e¦ Surcharye: 5 G. OQ pd r,. e t e ~
Mix. Chorpes:
Total:
BY Date Poid:
Dote of Irup.: IrKp.:
CITY OF E4GAN ~ SEINER SERV~CE PERMIT
3~~3G Pilot Knob Road p~,{IT NO.: ~d29
P. U. Box 21199 - 9- 3
Eagan, MN 55121 1
uiy No. of Units:
pwnar:
Addreas: nnamon Be
Sits Add~ess: 445 Slater Road L
Plumbe~: '"eSto a S ~t N . P
; g 83 3~ 2g 425.Oi3 oc?
1 qr» to ee~ll wi~ tM C~! ~ E~~ C.onn~ctlon Cho~:
Orah~eoN. kaount Dspoait:
Permlt Fw: 1 ~ .~Zt~...t~-
Surdwr'W: 5n t~d _
BY Misc. G+o~
Dote of Insp.: Total:
~ pot~ Patd:
This request void 1~_ L ~ g a C~• ~ ~Q ~
18 mpn~hs from 1. ' R` 3 r~ ~
~n~a. - ~~,s~
Renuest Uate Fire No. Fough-in Inspection
~ Feq red? ~ACady Now Q Wil, ~VOtifY Inspec-
(~p11 ~ o yes ?No Ready
Licensed Elechical Conhacmr I hareby request ins0ection of above
? Owner electrical work installed at
Sveet AtlAress, Bo or Route No. ~ C~
4s7 ~L
ecuon o. Township N~me or Nn. Fanee o. nty
AK c~V"~
Oc upant IPHINTI ~ Phone No.
NiY- n. 3Z-
Power Supplier Ac~Yr~ss
KO t~ ~V ~C ~ Rh ,vG ti
lect ical Convactor (COmpany Namel Cuntractor" mense No.
N~ - c~ 4(~~t4~
Mai ing AAJress (COnhacmr or Ownerr ~iking Instailation)
0~N ~ ~o V S:~y32
Aut rized SiBnaturp~ICont ctor~Owner Making Installatio I Phone Numbevr "
~V
THIS INSPECTION REQUEST WILL NOT
MINNESOTA TATE 90AND OF ELECTqICITY ~
Grigga-Midway Bltla. - Room N•191 BE ACCEPTEP BV THE STATE BOARD
UNLESS PNOPEN INSPECTION FEE IS
1821 UniversitY Ave., St Paul, MN 56106
Phone (6t2~ 287-2117 ENCLOSED.
flEQUEST FOR ELECTRICAL INSPECTION EB-OOWl-O-0
, See instruciions ~ar completing ihis fo~m on back of vallow copy.
""X" Below Work Cove~ed by 7his Request ;q a(
AAtl N6P. TYPB of 9uiltlin9 Aaaiionces Wirod EquiPment t` ed
Home Fiange Temporary Servi~~
Duplex Water Heater Li~htiny Fintures
Apt. Bufldin~ Dryer Electric He~tin
Commercial Bldg. Furnace Siio Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tank
Fann ome. pem y ~her ISnerifyl
~ er uemfy Offier O~her
Compute /nspection Fee Below
N Fee SarvicaEnlrenceSize k Fee Fexde~s/SUb~eetlers N Fee Circuits
0 to Z00 Am s 0 to 30 Am ~s 0 to 30 Am ~ s
Above 200 Am ~s 31 to 100 Amps 31 to 100 qm
Swinmin Pool Above 100_Am s Above 100_.Qm~s
Transformers Irrigation Booms Pdrtial; Other Fee
Signs Speciallnspection ~~q
Nertwrks S T~70vy T
~ a-~ .
Boueh-in ~a[e
~ ~ cal
~~Q~~ Inspectaq ~e~eby
certify Ihat the nbove
Final A1e inspeetion has been
~ ~ae.
Thls ~epuesl voitl 18 mantta from ~
Tfi~s reques~ void O/~/p A -
16`opnths (rom O o J
E 43 6 8 3 c~ a ~ ~~i
flequest ~ate -.Z Fire No. Rouph-in InsVer.tion
i Reqmred7 ~Ready Nuw ill Notify InsDer
~/3/~~ ?~es ?NO ~or When Ready
~censed Elecuical Contractnr I haraby repuest insPec~ion ot ebova
Owner electrical work instal t
Sveet Atldress, Box or Route No. ~~~v~
~~S ;Ltip`u-
ectmn o. Towns~ip Name or No. Banpe o. Count ~
Occup~ (PPINTI Phone Nm.
I ~7% ~L ~ 7 J -
~ower Supplier Address
EI ct~cal Co lr ctor 1 o~pa~Nai ~ ~ ~ Contror.tor's License No.
~ U ~ ~ ~
J
MailinB AtlJress IContt~a r or Owner Making Installation)
~ l!~ ~6-B~~'I,t ~ ~O ~ ~ S5 ~D'
Au~horiz d Si naWre ~Conh tor Owner fny Installatiunl one Number
THIS INSPECTION PE~UEST WILI NOT
MINNESOTA STATE BOAND OP ELECTPICITY
Griqgs-Mitlwey BIdB• - poem N-791 BE ACCEPTEO BY THE STATE eOAHD
1821 Universitv Ave.. St. Peul. MN 55104 UNLESS PflOPEP INSPECTION FEE IS
ae..~o tat21 fia9-ORan ENCLOSED. ~
~k:/`~ REQUEST FOR ELECTRICAL INSPECTION Ee-ooooi-os
~~p~ 1 See instmctions br completing this lorm on back of vellow copv. ~&jf'9-,5!
E'+ ~ H 3 ~"X"" Be1ow Wo~k Covered by lhis Request ~y~ SCp,s'
Hdtl flwp. Type ol Builtling Aoo~iancna WireE Equiyment WireA
Home Range Temporary Service
> Duplex Water Heater Lightiny Fixtures
ApL Buildlnc~ ~ryer Electric Heaun
Conunercial Bldg. Fumace Silu Unln,ider
Industrial BIAg. Air Conditioner dulk Milk Tenk
Farm O~ne~ oe~:~ y O~ne~ lSner:~ivl
~ er Sycc~iy Ot er Ofi¢r
ompute lnspection Fee Below
p Fee ServiceEntrence5ize H Fee Fexders~5ublentlers ~ Fee Cirwits
U to 200 qm ~s 0 to 30 Am s 0 tn 30 Am
Above 200 qm ~s 31 to 100 Amps 31 to 100 Am
Swimming Pool Above 100_Am s Above 100_Am ~
Transiormer5 Irrigation Booms Partial~bth Fee
Signs SVeciallnspection D
Nertyrks . . 5 ~ TOT FEE
E_ a..~ c~-rr~Q. a .
HouBh-in Oate
I, the al
nspectar, ~aroby
cerlify that t~e abova
Final r ~~e~ inspection has been
~ made.
i . ,
•~Iereyue5tvoi07Bmontl~efram ' ~ ~
~ CITY OF EAGAN ~T
3795 Pilat Knob Rmd legon, MN SSI'!2 l~l..~ 8221
" PHONE~ 431.8f00 -
BUILDING PERMIT Receipt .{k 1~0~9
Te M aad h. SF DWG/GAR En,ya~~ $55,000 pate July 8 _ ~q 83
S~te Address 4457 Slater Road E~~ g Occ~ponh R-3
Lot 6 Bixk 2 Sec/Sub.Cinnamon Ridge 3rd Alror ? Zonin9 ~PD) R-1
pa~~ # 10 17401 060 02 Repair ? F~re Zone NA
Enlarge ? Type of Const. V
~ Na,~ _ Zachman Homes, Inc. ~y„e ~ # Srories
W
~ Address ~~60 Mitchell Road Damolish ? Length 42
Eden Prairie pho,M 937-9520 G~oee ? Depth 26 Sq. Ft.-
Name Keymen Construction, Inc. Avw~ola Fees
o~ Addreu 5952 Woodland Circle Assessmenr Pern,it z~s
Mtka. 55343 ph~ 934-1218 warer 8 Sew. Surchorge 27 • 50
Police Plan check 149.00
~w Nume Fire SAC 525.00
Address Enp. Water Conn. 450.00
iW Ci Phone Piannar WoterMeter 60.00
Council Road Unit 250.00
I here6y acknowledge thot 1 have read ihis opplicotion ord stata thot Bldg. Off.
the informotion is torrect and agree to comply with all cpplicoble APC Total 51759.$~
SMfe of Minnemto Stotutes and Ciry af Eogon Ordirwnces. ~
Sipnoture of Pe~nittee
A Buildinq Pem,~r Is Issued m: Keymen Construction, IIIC. e~ ~ ezpress tonditlon Ihnt
all work sholl ba done in accordence with all opplicable Sf of Minnewto 5 tutee ond City af Eupon Ordlnorxes.
Buildirq OfHdol e ~2--
~
CALVIN H. HEDLUND 7726 MORGAN AVE, so."
MINNEAPOLIS, MINN. 55423
~and Surv~yor prll Enpin~~~ PHONE NO. 866-2523
srrr~er~ar~s G'ert~f
"t~ate
JOB N0. `~27
SURVEY FOR~ Zachman Homes
DESLRIBED AS~Lot 6, B1ock 2, CINNA.~lON RIDGE 3RD ADDITION, City of Eagan,
Dakota County, Minnesota, and reserving easements of record.
- _ ~
9i7_75 92.00 N4~°27'ZS^w ~9i9.Z_J
- - ~ ' - - - l,.=- - - -y/ - - - ~D
K /
Z 5~ 1 ~~s~ / 'Pr
~ ~ - oz - ' ~ N ~~'p.ti
~ PciPIJ~ Tt~ ; p~ ~ ap d.
~~s \ N \ ~a ~ n ~
~ ~ V / Z ~o.o f.9 s~KES
2 2 {0; o Top of FoD~daFion = 92S.ry•:
lu'-o ~ S.TAKF.~S . ~ ~ - ~
I ~S z~~'~' w Basemen~ Floora 9ZS.7:.
> ~
!1 n~~ ~1,~ , Garage F~oor, 9E~5.sF-
F I
N n-~/ Proposed Elevdf/ons O
L_.:' ;-~3 ,t ~~3.23 a 14. a 13r~ j i 1_ - 1 9
! r Esiatln Elevei/onS
929~.13"'~. / ~92.3,91 ; ~
{ / g+45 N4i°27Z5'wR=45 ~ . Drainaq6 Direction
/ \ Denoies Loi Co~ner O
/ \ '
~ 4`~~ 7
SLATER ROAD
~ . -
CERTIFIGATE OF SURYEY
I MraDy certify thaf on 6,~31~'/ I wrv~y~d tM prop~riy Mserib~d oboJ• and thot
tna obove plot Is o correct r~pr~s~ntotion of sold w~v~y.
Galvin N. N~dlund, Minn. R~p. No. 58~2
City of Ea�an
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use �j
Permit #: �/
7
Permit Fee:
Date Received:
Staff:
2010 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: O4/? /ZelA2 Site Address: t4 �J/C i eD "kw 575704-0.2—
Tenant: Suite #:
RESIDENT / OWNER
rF.
Name: ,4 €_ . re o Phone: ,' , �i /J
>ii�/�/
t
,-tee�'�,,. ,,1f
Address / City / Zip: 5 7 artier IZ D t� rn/ " 557, -02-
Applicant is: X Owner Contractor
TYPE OF WORK
Description of work: e -f® 0 c
Construction Cost: Multi -Family Building: (Yes / No )
CONTRACTOR
Name: License #:
Address: City:
State: Zip: Phone:
Contact: Email:
COMPLETE
In the last 12 months, has
No If yes,
THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
the City of Eagan issued a permit for a similar plan based on a master plan?
date and address of master plan:
,Yes
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor:
Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One CaII 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.c opherstateonecall.orq
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
x ActSA 4' f eJe fi7411
Applicant's Printed Name
x
ApplSignature
Page 1 of 2
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA118161
Date Issued:10/29/2013
Permit Category:ePermit
Site Address: 4457 Slater Rd
Lot:061 Block: 2 Addition: Cinnamon Ridge 3rd
PID:10-17402-02-061
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 .
David Luna
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 -
Abdulatif A Barento
4563 Horizon Cir
Eagan MN 55123
(612) 227-2794
Armor Construction Inc
5981 148th Ave NW
Ramsey MN 55303
(651) 491-2616
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA118161
Date Issued:10/29/2013
Permit Category:ePermit
Site Address: 4457 Slater Rd
Lot:061 Block: 2 Addition: Cinnamon Ridge 3rd
PID:10-17402-02-061
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 .
David Luna
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 -
Abdulatif A Barento
4563 Horizon Cir
Eagan MN 55123
(612) 227-2794
Armor Construction Inc
5981 148th Ave NW
Ramsey MN 55303
(651) 491-2616
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA124504
Date Issued:07/03/2014
Permit Category:ePermit
Site Address: 4457 Slater Rd
Lot:061 Block: 2 Addition: Cinnamon Ridge 3rd
PID:10-17402-02-061
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Kathy Will
2609 Hwy 13 W
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 -
Abdulatif A Barento
4563 Horizon Cir
Eagan MN 55123
(612) 227-2794
Airic's Heating Llc
2609 Highway 13 W
Burnsville MN 55337
(952) 345-0032
Applicant/Permitee: Signature Issued By: Signature