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1674 Skywood LanePERMIT City of Eagan Permit Type:Building Permit Number:EA128090 Date Issued:10/27/2014 Permit Category:ePermit Site Address: 1674 Skywood Lane Lot:15 Block: 1 Addition: Oakbrooke 6th PID:10-53765-01-150 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 . Lisa Nyberg 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 - Yevgeniy Vinnik 1674 Skywood Lane Eagan MN 55122 Property Claim Solutions Llc 2005 Pin Oak Dr Eagan MN 55122 (651) 994-2028 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA128420 Date Issued:11/12/2014 Permit Category:ePermit Site Address: 1674 Skywood Lane Lot:15 Block: 1 Addition: Oakbrooke 6th PID:10-53765-01-150 Use: Description: Sub Type:Siding Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please leave printed pictures of house wrap on site for the final inspection. When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to ensure maximum ventilation to attic. Call for final inspection after installation. 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 - Yevgeniy Vinnik 1674 Skywood Lane Eagan MN 55122 Property Claim Solutions Llc 2005 Pin Oak Dr Eagan MN 55122 (651) 994-2028 Applicant/Permitee: Signature Issued By: Signature RESIDENTIAL BUILDING " p n Permit Application C a City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 I> Ci 4 ? ? Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Requirements RemodekReoair 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 Recd 1 set of Energy Calculations Addition - indicate if on-site septic system _ On-site Septic System 3 copies of Tree Preservation Plan if lot platted after 7/1/93 Rim Joist Detall Options selection sheet (bldgs with 3 or less units Date O J / 2 0 Site Address / 6 Ccee 't / 2- 0 02 /?Y S au? 17 ® L1J00 el Construction Cost 5_0 00 ?_ ri/? Unit/Ste # Description of Work !^1t f p l v e ?d L 2 t/e Multi-Family Bldg _ Y N Fireplace(s) ?o _ 1 _ 2 Property Owner O .- r f ?r/e v? l Telephone # (,;r(2) 2 Y S ^2 / 6 Contractor Address State Zip City. Telephone # ( ) COMPLETE THIS AREA ONLY IF Energy Code Category - Minnesota Rules 7670 Cateaorv I • Residential Ventilation Category 1 Worksheet (J submission type Submitted • Energy Envelope Calculations Submitted Licensed Plumber Mechanical Contractor Sewer/Water Contractor A NEW BUILDING _ Minnesota Rules 7672 • New Energy Code Worksheet Submitted Telephone #( Telephone #( Telephone #rpy, I ? i a l ii ?' C , .,. I J v l I hereby apply for a Residential Building Permit and acknowledge that the into ion is co ete and ( curate; that the work will be in conformance with the ordinances and codes of the CitI I Eagan and7t e a e 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. 41 Applicant's Printed Name Applicant's Signature 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 PlbgXor _N ? 25 Miscellaneous Work Types ? 31 New 'Illi( 35 Int Improvement ? 38 Demolish (Interior) ? 44 ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 ? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 ? 34 Replacement *Demolition (Entire Bldg) - Give PCA handout to applicant Va luation ? Occupancy R-3 MC/ES System Census Code Ll3 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 A Framing _ Fireplace - R.I. _ Air Test - Final Insulation ? 30 Accessory Bldg ? 31 Ext. Alt - Multi ? 33 Ext. Alt - SF ? 36 Multi Misc. Siding Fire Repair Windows/Doors 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 mot' Building Inspector MURNSVIJLJ.E Heating & Air Conditioning, L.L.C. 12481 Rhode Island Ave S, Savage, MN 55378.952-894-0005 Orstat Test Report for Job#. '` f ? `l Address 'ft f. "? v?! ., l roc+r? j. (1/t:L city Occupant Date of Install Type of HT. F/A HW Space HT Unit HT Mahe L R. F.r Model Serial Input fi iu 1, Pilot Type HOT SURFACE IGNITOR Pressure w C02 Input CFH 7 , 02 Y Stack Temp CO Date Tested R) - Company BURNSVILLE HEATING & AIR CONDITIONING Technician C0 Address: 1674 Skywood Lane Lot: 15 Block: 1 Subdivision: Oakbrooke 6th Zip: 55122 THE FOLLOWING ITEMS WERE/WERE NOT COMPLETE AT FINAL INSPECTION ON ,) 67--0 j Yes No Comments Final grade - 6" from siding Permanent ste s - ara e Permanent steps - main entry Permanent driveway Permanent gas Sod/Seeded lawn Trail/curb damage Porch Lower level finish Deck Fireplace • Verify with your builder that roof test caps from the plumbing system have been removed. • Turn off water supply to the outside lawn faucets before freeze potential exists. • Call the City's Engineering Department at 651-681-4645 prior to working in right-of-way or installing irrigation system. BUILDING INSPECTOR cd/bldginsp/forms/2002/final inspection checklist Site address: I IG7 ? 4 Q rr« r ?- Lot L115 Block 0 Subd. On April 15, 2000 the Minnesota Energy Code, Category 1 Building Requirements for insulation protection, air tightness, and ventilation, was adopted. As a result, the City of Eagan is requiring that the following information be submitted prior to issuance of a Certificate of Occupancy. This structure: is constructed to meet minimum requirements of the Mn Energy Code, Chapter 7670 OR This structure. will be constructed to meet more restrictive requirements of Chapters 7672 or 7674 APPLIANCE GAS ELEC MANUFACTURER MODEL BTU'S VENTING TYPE Water Heater IAb M © -5,?-qs J4-- Furnace -a1 Fc- s oo ;?? Dryer EXHAUST SYSTEM LOCATION TYPE MODEL CFM's VENTED YES NO Kitchen kitchen Bathroom 1 r c( ?? SD1? F \J _ 80 Bathroom 2 t *. t 1? F V _0s V o 5D 4,7 Bathroom 3 fw S - o o Bathroom 4 i V - Other FIREPLACES LOCATION GAS WOOD MANUFACTURER MODEL BTU'S VENTING DIRECT ATMOS YQ 6. I hereby acknowledge that the above information is correct and agree to comply with the Minnesota Energy Code and City of Eagan requirements. '24"(2 ignat Company Name 5-), Z ?a3 Date This form is the responsibility of the General Contractor. PLUMBING (RESIDENTIAL) Permit Application ?j City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 Please complete for: Single Family Dwellings Townhomes and Condos when permits are required for each unit Date/ Site Address Unit # (? Telephone # (e(a) Property Owner J) r S Contractor l oNv9.- Address 745d r?l'S?, City Ip State & '(/ Zip "14 14 4 Telephone# ff-/0 Y The Applicant is Owner Contractor ` Other Septic System _ New - Refurbished Submit 2 sets of plans and MPC license $ 100.00 Includes County fee. Additional consultant fees may apply. Alter ions To Existing Dwelling Unit, Including r heater d t Addi f dditi l t ft di $ 50.00 ener an wa e 1 ng ixtures ower eves r room a ons, exc u ng wa er so _ Abandonment of septic system Water turnaround (+ 5/8" meter if needed - $121.00) Other: D ' t _ RPZ _ new installation _ repair _ rebuild ? 30 00 $, f I _ Lawn irrigation system l ?t By ?1 _ Water softener _ Water heater --??_`` !$ 15.00 replacement _ additional $ .50 State Surcharge JU $ SC) Total I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete and accurate; that the wort: will be in conformance with the ordinances and codes of the City of Eagan and with the Plumbin ode ; at I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; th he wo ill be i cordanc -the approved plan in the case of work which requires a review and approval of plans. Applicant's Printed Name Applicant's Signature L'i 5 ??'t-U3 RESIDE ITN AL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55'122 651-6814675 $L `.??13`? 1 `'tlE r?`1 ? o0 9-0.so New Construction Requirements • 3 registered site surveys showing sq. ft, of lot, sq. ft. of house, and all roofed areas Remodel/Repair Requirements • 2 copies of plan L? C\ 15 , (20% maximum lot coverage allowed) 1 sel of Energy Calculations for heated additions • 2 copies of plan showing beam & window sizes; poured found design, etc.) • 1 site survey for exterior additions & decks • l set of Energy Calculations ?j • Indicate If home served by septic system for additions • 3 copies of free Preservation Plan lot platted after 711/93 • Rim Joist Detail Options selection sheet (bldgs with 3 or or less units) DATE IL) q Jo'2 VALUATION l I O t 8O `? CL l SITE ADDRES TYPE OF WO IULTI-FAMILY BLDG _Y / N FIREPLACE(S) _ 0 lC 1 _ 2 APPLICANT 'PoVk tijjoiweS STREET ADDRESS $?S Ncr'?weS+ &?? A 4-4*ITY STATE /14A( ZIP CELL PHONE # lP l 2? -3(o9-3tee FAX # r051 -WY-6.537 PROPERTY OWNER TELEPHONE # ----------------------------------------------------------------------------------------------- COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category MINNESOTA RULES 7670 CATEGORY I MINNESOTA RULES 7672 (J submission type) • Residential ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted • Energy Envelope Calculations Submitted Plumbing Contractor: Phone # 61 Plumbing system includes: Wat oftener _ La ',t Water Heater _ of R-113 hs 'i -- No. of Baths( AA d LSC : C 1 Mechanical Contractor: R V'nru;lke hY " lt1r 1 n Phone # Mechanical system includes: Air Qj;Wdifioning Heat Recovery System Fee: $90.00 -09? -DDS Fee: $70.00 Sewer/Water Contractor: C?1ro ?Yt/rc t5 Phone 0 -7c? _ ?2 --------------------------------------------------------------------------------------------------------------------------- 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 Ordinances. Signature of Applicant OFFICE USE ONLY / Certificates of Survey Received Tree Preservation Plan Received _ Not Required J Updated 4/02 -'? t OFFICE USE ONLY sZ a )O-D ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? w 30 Accessory Bldg 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt- Multi f ? 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 V gp 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 0(a (> Occupancy u? MC/ES System Census Code 401 Zoning City Water SAC Units Oi Oi Stories Booster Pump l l Nbr. of Units Sq. Ft. 37 PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const -V` Width REQUIRED INSPECTIONS v _x Footings (new bldg) FinaVC.O. Footings (deck) r Final/No C.O. _ Footings (addition) _ Plumbing Foundation _ HVAC _ Drain Tile Other Roof _ Ice & Water X F i _ Final _ Pool _ Ftgs _ Air/Gas Tests -Final ram ng Siding Stucco Stone _ _( Fireplace _[ R.I. _? Air Test Y Final _ _ Windows (new/replacetnent) Insulation _ K 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 X654 "LI r Total Building Inspector X is = -o /7S' s ul'tdoom 9 2 Xzj I is 7/ 3 7Z 3? Zc?to ,] PULTE HOMES OF MINNESOTA RECAP SHEET DATE: 10/19/2002 JOB NO: 0550-415-01 LOT: 15 COMMUNITY: OAKBROOKE PATIO HOMES ADDITION: 6th ADDRESS: 1674 Skywood Lane CITY: EAGAN MODEL NAME: BRISTOL WC MODELM 17934 ELEVATION: 1 BUYER NAME: Boris Tsvetovat ADDRESS: 3150 Farnum Drive unit B CITY: Eagan STATE: MN HOME PHONE: 651-452-9865 WORK: 651-225-3913 WORK: 651-245-2163 SALES REP.: KATHEE SHELDON PHONP: 651-686-4643 ??onuft mm OTY,' OPTION; DESCRIPTION", _ 'e',_ ;. LO/kTt(jN£ x _'' ,_ EAGFI B aPRI`CE 1 17934 BRISTOL-W.O. LOT PREMIUM 1 99000 FOUR SEASON SUNROOM 1 99000 2 1/2 TON CENTRAL AIRCONDITIONING 1 25015 CLNST.DRS W/PF OAK 1 17043 ELECTRIC PANEL-BASEMENT 1 17006 OMIT RANGE/RUN 220V ELECT, 1 13077 WHIRLPOOL TUB 1 31011 LAUNDRY TUB SNGL COMPRTMNT 1 18015 ELEVATION #1 1 99000 OMIT ALL STANDARD PAD AND CARPET MAIN LEVEL AND STAIRS AND SUNROOM 1 28053 42 UPPERS-BASE I NOTES: zing BLOCK: 1 UNIT: 41501 STATE: MN ZIP: 55122 GARAGE: RIGHT 0 ZIP: 55121 STAIN: CIDER MNr'1' 1* "(NPL'IANCE REPOR'T' Min,.. I , (anyrgy Comdr wT,•1, l '-,rtVe1.9ir,11 '.n Pe rm Checked by%DatP (,(11111 i„Lr,r q ST11 1 1 (1; 1111"pol %1 zorfl : : C0I1:'1 r1,"rIMI TYPIE: Single Family T.)A.LI, 7.±1n0 DAII I-AN;': R/3/00 911111 1 1, 1 n!TM, WALKOUP F,T,RVAT11,M If' c?1,rl: 1 r.: T?Ar?.tir;a Re,ln . -I 117\ 1AFi Y(_,'l, ., - 285 25 1" P-1 1 ^r Th,--111 Codo Area or. Cavity Cont. Glazing/Door perimeter R-Value R-Value U-Value 1342 -44.0 0.0 CF 1 " 1 WA1 16" OX, 1986 19.0 ; „} Frmwz! 2.0 1 , , . 1.69 10.0 11 0 2.0 0.0 BSf11 . u9.n' ht-/8.3' 1)9/9.0' i.usul 112 0 0 F?p.1'1 113.,' ht/3.1' bg/?.5' inaul 20 10.0 . 0 350 1. r1 ,1., '' 2 ,ti nr}n r ?r (L,r,r A},rm ;rm9 94 . 0. 350 _ 38 }TVi, Ilf`r91:^PP: Furnace, a?.U AFTTF: ---------- ---- ---------- nTAJTNENT: The proposed building design described nd other here calc is ulations coll.. n1:. with the building plans, specifications, ropose Th a d building has been sublril e p l-i with the permit- application. f the Minnesota Energy Code. desi,,,t -T to meet the requirements o F311i 1,? ., /r''r-,5i-gner Date /Z a a LOT SURVEY CHECKLIST FOR RESIDENTIAL • BUILDING PERMIT APPLICATION PROPERTY LEGAL: L gJ gL,,K ?GL/? L'?tD? 1 P, (a ?yC DATE OF SURVEY: ?? S D LATESTREVISION: a O? d/l ? rd/ ? W ? ? Gds ? ? d7 c m r U L Q 11 11 ? DOCUMENT STANDARDS • Registered Land Surveyor signature and company • Building Permit Applicant • Legal description • Address • North arrow and scale • House type (rambler, walkout, split w/o, split entry, lookout, etc.) • Directional drainage arrows with slope/gradient % • Proposed/existing sewer and water services & invert elevation • Street name • Driveway • Lot Square Footage • Lot Coverage ELEVATIONS / Existing 1/ ? ? • Sewer service (or Proposed) ?/ ? ? • Property comers GG ?/ ? • Top of curb at the driveway and property line extensions ? Pd ? . Elevations of any existing adjacent homes ? ? . Adequate footing depth of structures due to adjacent utility trenches ? ? • Waterways (pond, stream, etc.) Proposed ? ? • Garage floor ? ? . Basement floor L3/ ? ? • Lowest exposed elevation (walkouttwindow) M ? ? ? . Property comers ? ? • Front and rear of home at the foundation PONDING AREA (if applicable) y ? ? • Easement line d ? ? • NWL ? ? • HWL ? ? • Pond # designation ?/ x ? • Emergency Overflow Elevation (Y ? ? • Pond/Wetland buffer delineation ?/? ? I(Y ? ? C7 1=1 I l Fl EV C9/ 11 ? ? • Lot lines/Bearings & dimensions • Right-of-way and street width (to back of curb) • Proposed home dimensions including any proposed decks, overhangs greater than 2', porches, etc. (i.e. all structures requiring permanent footings) • Show all easements of record and any City utilities within those easements • Setbacks of proposed structure and sideyard setback of adjacent existing structures • Retaining wall requirements, if an Reviewed: G:/FORMS/Building Permit Application M Surveyor's Certificate SURVEY FOR :PULTE HOMES DESCRIBED AS :Lac 15, Block 1, OAKSROOKE 6TH ADDITION, City of Eagan, Minnesota and reserving easements of record. DEC 11 RECD ?15 ? ?'? L'm A, q8 v? 929.7/ ?? a 7 \I a47.?_6 E I) V 0 r Vacant 930.40 b 'Vsi?o / ^,?ry 7 0 5? o? ',,, ^? SJJ 000 G? O •6 qo4? V? a9\•l 3\O s 0? ?oQFo3 0 92t.0 y? 931.6 ¢ Q-° 4° ? ? / 61 aF 3:1 RA rrS 1m •930.9 a° ?° or Rein ning W:1 VM ry? a? Be Required ? aoa / e Vacant 422.4 POND Bufrer BP-35.1 S? L Sewe / NWL= 897.0 14 A-0 Ze HWL= 913.8 LOT SQ. FOOTAGE = 3,080 HSE. SQ. FOOTAGE = 1,686 LOT COVERAGE = 54/ # 17934 PROPOSED ELEVATIONS BENCHMARK, Top of Foundation = 932.5 Garage Floor = 931.4 EL= # 93311.19 91112 .1 TNH Basement Floor = 923.5 EL Aprox. Sewer Service = 920.5 Proposed Elev. = 0 MIN. SETBACK REQUIREMENTS Existing Elev. _ Drainage Directions = Front - House Side - Denotes Offset Stake = SCALE: 1 inch = 30 feet Rear - Garage Side- _..?VU a.n "t laJOB NO. HEDLUND HEREBY CERTIFY THAT THIS IS TROEr'ANO OfIq T TY'R SURVEYS 02R-776 OF THE BOUNDARIES OF. THE ABEUTPROPER'fYAS SURVEYED BY ME OR UNDER MY DIRECT Sq.ERVISION ANDpDOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROAO4ENTS, EXCEPT AS SHOWN; PLANNING ENGINEERING SURVEYING BOOK: PAGE: Jt)rt C 1 ? 2005 Pin Oak Drive r TI-TA'j r; Eagan, MN 55122 DATE ?CAD FIL E: Phone: (651) 405-6600 Y IND RSURVEYOR Fax: 651 405-6606 rd aUM 14376 Oakbrooke 5 ( ) "7l r IA--x Y ?. PERMIT Permit Type: Building City of Eagan Permit Number: EA105975 Date Issued: 08/06/2012 Permit Category: ePermit Site Address: 1674 Skywood Lane Lot: 15 Block: 1 Addition: Oakbrooke 6th PID: 10-53765-01-150 Use: Description: Sub Type: e-Reroof Construction Type: Work Type: Replace Description: House & Garage Census Code: 434 - Occupancy: Zoning: Square Feet: 0 If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar. Pictures are Comments: not acceptable in lieu of inspections. Carbon monoxide detectors are required by law in ALL single family homes. BL - Base Fee $4K $103.25 0801.4085 Fee Summary: Surcharge - Based on Valuation $4K $2.00 9001.2195 Valuation: 4,000.00 Total: $105.25 Contractor: Owner: - Applicant - Krech Exteriors Inc Yevgeniy Vinnik 5866 Blackshire Path 1674 Skywood Lane Inver Grove Heights MN 55076 Eagan MN 55122 (651) 688-6368 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. Applicant/Permitee: Signature Issued By: Signature