4131 States Ave „ „ .
SEVWR de WATER PERMIT OFFICE USE ONLY
CI'flf OF EAGAN METER #~~y y~d ~a PERMIT DATE 01/06/92
3830 Pilot Knob Rd. 12466
Eagan, MN 55122-1897 cHiP ~ O/9~ PERMIT #
METER SIZE B.P. RECEIPT # C 016673
ISSUE DATE~ 4 B,P. RECEIPT DATE 12/31/91
DATE DEC 31. 1991
_ PRV - BOOSTER PUMP
~
SITE ADDRESS 4131" STATES AYE PERMIT REQUESTEO
LOT 22 BLOCK 2 SEClSUB STAFFORD PLACE
_ x SEWER X WATER - TAPS
APPLICANT: COMM/IND X RESIDENTIAL
ADDRESS:
CITY, STATE ZIP X NEW - EXISTING
PHONE:
Lawn Sprinkler Meters are to be Installed
PLUMBER: REGENCY PLUMBING Ahead of Domestic Meters on Water Line.
ADDRESS: 320 FRONT AVE - Credi WILL NOT be gi en for Deduct Meters.
CITY, STATE ST PAUL MN Zlp -55117
PHONE: 489-7344
I A E O COMPLY WITH CITY OF
OWNER: SEASONAL BUILDExS INC EAG O D
ADDRESS: 4580 SCOTT TR STE 210
CITY, STATE EAGAN MN Zip 55122
PHOF 454-5971 N URE EN METER ISSUED
n
PLd 6i ALL W`TWO WOF(KING n)/k'YS F~R P~tOCiSSING. CALL 454-52 OR INSPECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT.
........,..i . . ..,-_,i .111 ..11 _ - 11,121 ~ . 1 . , y . .Nr' .
SEq'VER &WATER PERMIT OFFiCE USE ONLY
CITY t1F EAGAN METER # PERMIT DATE 01 /06f 42
3830 Pilot Knob Rd. 12466
Eagan, MN 55122-1897 CHIP # PERMIT #
METER SIZE B.P. RECEIPT # C 016673
ISSlJE DATE B.P. RECEIPT DATE 12 / 31 / 91
DATE DEC 31. 1991
~ PRV - BOOSTER PUMP
SITE ADDRESS 4131 STA7ES AVE PERMIT REGIUESTED
lOT 22 BLOCK ? SEC/SUB STAFFORD PLACE
X SEWER X WATER _TAPS
APPLICANT:
AQDRESS: - COMMIIND x RESIDENTiAL
CITY, STATE ZIP x NEW - EKISTING
PHONE:
REGENCY PLUMBING Lawn Sprinkler Meters are to be Installed
PLUMBER': Ahead of Domestic Meters on Water Line.
ADDRESS: 320 FRUNT AVE Credit_WILL NOT be giuen for Deduct Meters.
CITY, STATE ST PAUL MN ZIp 55117 ' j~
PHONE: 489-7344 X.
I A EE TO COMPLY WITH CITY OF
OWNER: SEASOIVAL Bf1ILDEBS INC EAGAN ORDINANCES
ADbRESS: 4580 SCOTT TR STE 210
CITY, STATE EAGAN MN Zlp 55122
PHONE: 454-5971 SIGNATURE WHEN METER ISSUED
PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 4545220 FOR INSPECTIONS. FOR STORM
SEWER PERMlTS, CONTACT ENGlNEERING DEPT.
. , .
~ 0 ` ~
~ CASH RECEIPT
CITY OF EAGAN a~
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE ~ I~ I 19 L~
wcl
aMOUrJr
i Xj ~LLAAS
f~ CASH 4<CHECK
CT
FUND OBJECT AMOUNT
Thank You {BY
C 016673~
~
Pv*-Fde cwy
r•. ~-r-- ,.~rz. , s'~ .,~v~r+ -i _ . . . : T'r,.r_ .
s CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-19YJ, Eagan, MN 55121
" PHONE: 681-4675 0 ~
BUILDING PERMIT Receipt # i~' t
To be used tor S~ ~/GAR Est. value ,000 Date DEC 31 1991
Site Address 4131 S?ATES AVE
Lot 22 Block 2 Sec/Sub. STAIrlOBD PLACE OFFICE USE ONLY FEES
Parcel No. Occupa"cy A-3 'tin) 595.00
zoniny R-t BId9. PermR
NBmB SEASONAL AIlII.DERB IIIC (actual) Const V-1f Sudvrge 45.00
W~~ 4 STE (Albwable) Y-m 210 Plan Fievlaw 386•~ :
~ EAGAN !7H ZP 55122 of stories ~
p C+tY Lenytn
Phone 454-5971 oeptn sAC, city too•~
cc Name SAliE S.F. Total - SAC, nncwcc 650•~
~ S.F. Footprints - 6~-~
On Site Sewage _ Water Conn
~Q
city Ijp On Site Well ~ Weter Meter 95.
Mwcc syst~ gp .pp
$ pl~one X n~t. oePos~c
30.00
# Ciry water PRV Required _ S[1N Permil
I hereby acknowlege that I have read this application and state that the Booster Pump - SI1N Surcharge •50
information is correct and agree ta comply with all applicable State of 276,
~ Minnesola Statutes and City of Eagan Ordinances. ~ 7reatment PI
Signature of Permitee . c / , iAPPROVALS Road Unit 370. ~A
A euilding Permit is issued to: SEASOIQAL DUI LD6RS IIiC Planner - park ped,
on the express condition that alf work shall be done in accordance with all ~uncil
applicable State ol Minnesota Statutes and City o1 Eagan Ordinances. Bldg. Off. _ Copies
Variance - TOTAL 3,237.50
Building Official
Permit No. PermR Holdsr Date 7elephone #
S/W
PU,nnsir,c
Hv,ac
ELECTRIGJ~
ELEcrRic
hspsetion Oate InsP• Commentv
Fooiings I 112 912 U
FoundaGon
Framing ~ 9 Z `ID i"i,. •
Roofing
Rough Plbg. 7T
Rough Htg.
Isul. 19
Freplace
Final Htg. t;,; ~
Orsat 7est
Final Plbg. Plbg. Inspector - Noti(y Plumber
Const. Meter
EngrJPlan
sidg. Final
Dedc Ftg.
Dedc Fnal
Wall
Pr. Disp. c-?N[~~ ?~l1xt~! ~S~ t~ ~
~ .
~ .
C~tr#t#tratt
Citp of ~a~an
ioPpw#qLpltt Qf 1.~walng ~tt~tPtttDti
Tleis Ceriifwate issued pursuaiu lo the nequirmerrts of Secliore 306 af dre Uruform Buiiding
Code oai~f!'iirg thal at the lune of iuuance tJus mtruciure w+as in compliance witle rlre warious
ondinances of [he City regudaang building coaw=Wn or use For 1Jre following.
um aammaldion SE' = /ra wAg. hon& Nm
0o"-7 TYa _M/Mi - Zonina oiu;d Tya c.-. VN
owm armwft. SA90W R[T[Lnm Ic Add. 4580 9rrnr TRAII,, F.ar,ax
~ - 4131 STATES AVE[alE L-AHW r99, R'1, sTaFFrr?n pr.aU
Daca _...O3~26.19 -
, ewaa;os officiil _
POST IN A WHSPICUBUS PLACE
_~d~~ ~03~ a ~ slsa 9 0 12 7
00
Fequest Date /l Flre No. Rough-in Inspection
c ` j' 2 RepuireE~ ? Reatly Now ~SNTNOtily Inspedw
/ • / • •;1 fjy~s Ej N. When Reatly?
. I T icensed contraaor ? owner hereby request inspection of above electrical work at:
Job Adtlr ss (Stre9~ B x or 1 o City
~
J
J
Section No. Townsbip Name or No. Range No, Couny n
Occu n IPRI~ Ph No. _ 5-9 7
N
PowerSu~ Atldress
Electrpal ntraclor ~C mpanY Name ~actor§O nse N~
/
Mailing tlress ICO VactOro ner Makinq Installation
Authm
kis E SignaWre (COnva oNOwn r Making Inslallalion) Pbone Number
5'S/a 5` i~3~~ ~ 0 3 L
MINN STATE BOAHD OF ELECT ITV THIS INSPEGTION REOl1EST WILL NOT
Grlqgs-Midway BIAg. - Roam S173 BE PCCEPTEO BYTHE STATE 80ARD
1821 Unlverstty Ave., 5t. Paul. MN 55104 UNLE55 PROPEq INSPECTION FEE IS
Vhone(612) 642-0800 ENGLOSED.
REQUEST FOR ELECTRICAL INSPECTION lB ~-'~Aee-ooomC.oe
/ O S€e InsVUEtiaris lor com0leting this lortn on back oi yellow copy.
?
X" Below Work Covered by This Request V
~ ew Atld Rep. Type of Building AppliancesWired EquipmentWiretl
Home Range Temporary Service
Duplex Waler Heater Electric Heating
Apt. Builtling Dryer Other (Specity)
Commllndustrial umace
Farm Air Conditioner
OlherIsyecily) CoMrador's RemaBS:
Compufe Mspection Fee Below:
# . Other Fee # ServiceEnlrance5ize F e # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 700 Amps
Transformers Above 200 _ Amps Ahove 70 _ Amps
SignS Inspedor5 Use Onty: TO L SQ
Irrigaiion Booms
Special Inspection
AlarmiCommunication THIS INSTALLATION MAY BE DISCONNECTED IF NOT
• Omer Fee COMPLETED WITHIN 18 MONT S.
I, the Elecirical Inspector, hereby Aough-in oeie
certify thal the above inspection has F;,,ai oa~a
been made. •
OFFICE USE 3NLY
Tnis request mitl 18 momns ircm
Add,ress : 4131 STATES AVENVE Lot 22 Blk 2 Sec/Sub S gp pr.a`.F.
These items were/were not complete at the time of the final inspection.
at : 03/26/92 Yes No
Final grade (6" from siding)
Permanent steps - garaga
Yexmanent steps - main entry ?
Permanent driveway ~
Permanent gas ?
Sod/seeded grass bl
Trail/curb damage
Porch
Basement flnish ?
Deck V
Please verify with the builder the ramoval of roof test caps from the plumbing
system and the shut-off of water supply to tha outside lavn faucet before
freeze potential exists. ' _g
.~KLEOMM
White - City copy Yellow - Resident copy Plnk - Contractor copy
CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 11020004
BUILDING PERMIT PHONE:681-4675 Receipt # O
L~
To be used for SF DWG/GAR Est. Value $90, 000 pyte DEC 31 , ~g 91
Site Address 4131 STATES AVE
LOt 22 BIOCk 2 SBC/Sub. STAFFORD PLACE OFFICE USE ONLY FEES
Parcel No. occuvancy R-3 M-1
Zoning R-1 eldg. PermR 595.00
N2ff18 SEASONAL BUILDERS INC (ACtua1) Consl V-N Surcharge 45.00
W AddfESS 4580 SCOTT TR STE 210 (Allowa6le) V'N plm Review 386.00
~ Cily EAGAN MN Ijp 55122 L ng htories 44' L-
O
Phone 454-5971 Depth snc,cry 100-0~
¢ Name SAMF S.F. Total - SAC, MCWCC 650.00
Q S.F. Foolprinls -
~ Address ~N
On Site Sewage _ aler Conn 660_ nn
~Citi 7'jp On Site Weu - Walar Meter 95.00
MWCCSystem X 30.00
g Phane AaL Oeposil
City Water X
License # PRV Require0 _ S/W Permit 30.00
I here6y acknowlege that I have read this applicalion and sta[e Ihat the Booster Pump - SMI Surcnarge .50
infortnation is correct and agree to comply with all applicable State of
Minnesota Statutes antl Cityot~agan Ortli sTreatment PI 9 76 - nn
SignaNre of Permdee „~h•~ APGROVALS Road Unit _.37.0 .,$Q
A Building Permit is issuad to: SEASONAL BUILDERS INC Pla^^ar - Park Dad.
on Na express condilion thet all work shall be done in accortlance with all Council
applicable Stale of Minnesota Statutes and C~nit,y ouf Eagan Ordinances. Blag. pry. _ Copies
BuildingOflicial~ 1DT~1 I'~' Variance - TOTAL 3.237.50
1991 BUILDING PERMIT APPLICATION
CITY OF EAGAN
DEC 2 D •
SINGLE FAMILY DWELLINGS MULTIPLE DWELLINCS CO?IlHERCIAL
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 SPECTFIGATIONS
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.
TAT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER IATS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
?ESIRED. NO CHANGES WILL BE ALIAWED ONCE BUILDING PERMIT IS ISSUE?.
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: /ja~ Date:
Site Address
1 VI4eU ~(f e, OFFICE USE ONLY
Lot ZZ Block Z p 2 FEES
Occupancy Bldg. Permit Jr95)0a
/ QI„C Zoning R-1 Surcharge 5~100
Parcel Sub I~~ e Actual Const Plan Review ~00
Allowable SAC, City /0O"DO
Owner # of stories SAC, MWCC (0$O. CO
Length Water Conn. G ,00
Address Depth 'VOT/ Water Meter Si0 D
S.F. Total Acct. Deposit aiOD
City/Zip Code Footprint S.F. S/w Permit 0000
S/W Surcharge ISD
Phone On site sewage_ Treatment Pl.a2 Fi'i00
~yy( ,On site well Road Unit 390, DD
Contractor ~~I~t (,(.(~~~~,WIL • MWCC System ? Park Ded.
` City water ~ Trail Ded.
Address ~5`6D ~ir~ Trai ) i~-~ 21b PRV _ Copies
City/Zip Code Booster Pump 'J SUSTOTAL
APPROVALS Penalty
Phone Planner Lot Change
s ~ Council TOTAL
Arch./Engr. Il Bldg. Off.
Variance
Address
City/Zip Code
Phone #
1 J
agrees that all work shall be done in accordance with
( ignature o Contractor)
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
-~'~'P Ob ~o h~lb$
L99'S9 :.SFx
97 = ZXZZXZI,I
~ L11 ` 1-V~S 9
Z1oo~~ 15~ -
z,zh91 ~r,?~ ZLII
sl = 7/,x tj,sx ~~,s
h I = z/~S ~
ti h it
S6oL _Si X
~
t//1 , .
METRO 1875 PLAZA DR.
SURVEYDRS SUITE 200
,NC. EAGAN, MAf, 55122
Certificate of Survey for: (612)452-7e50
SEASONAL BUI LDERS
LEGAL DESCRIPTION: LOT?2,BLOCK._2_, STAFFORD PLacF
ACCORLIWG TO THE RECORDEO PLAT
THEREOF DAKOTA COUNTY,MINNESOTA
s rArEs
AVENUE
N 4° 30' E
ql322.00' `'.83.0 270.00 S
(G
9~
CIT 2 J
^
LO 40
a
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E A, la A ('y
ttFvrEwrEa o L0T 22
O
e ~ M
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~8•Oq 4~i~ W \ 1. /
I .
,ria's
G~~ tIeR~L ERI I 30
3y e Op . 41 °1?s'
,
LEGEN Y~n'F~'~Eb 4 C.EUEc- Sp[.~"'r~ /JD ~A"~
iNVERT EL.EVATION AT SERVICE EXTENSIONO
o pENOTES IRON MONUMENT PROPOSED GARAGE FLOOR ELEVATION •
a DENOTES WOOD NU8 SE7 PROPOSED FIRST FLOOti ELEVATION •
DENOTES EXISTING SPOT PROPOSED BASEMENT FLOOR
ELE VATiON E LE VATI ON
g DENOTES PROPOSED SPOT
DENOTES DRAENAGEIDIRECTION NOTE' VERIFY AlL FLOOR HEIGHTS WITH
FINAL HOUSE PLANS
l Mnby certify that this survey, plan or
reporf rw prepared ey nm or unMr mr y~
direct supe?viuon and that 1 om a duly 8radley .,.Swonson; Mn. Rep. Flo. I5235
; Roqistered Lan4 Surveyor undM tM • e~~ ~
. Lows of tM Stote of Minnesofa. Daf~ •
f-'XIP.:RIt.!R GNVF..l...fif"F: r1VF.f±A13Fi: „U" f f.!I^IF'I_ITATf.f:lN
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]r.,ntr ac{:ui~ 43~asonal Lsi,ii lr.lt=r=,
Bite address ,
:l y..frrt.a.l E?i:P(:I.SC-C:I wa) etr..eea 19:~5:'i; =~~la.f t..r--' 11== 21~.6
2)Total. ev,pn<,ed rnr.aFic:ei:l:iny
Wa1.1 c.a7.rulat.i.on
Total wi.nriow area Tota:L door area
Tcata7. g1ass r.loor- area
c Ft 1~F..ii
r.,t:.a:l. F i. r-F=Ka:I.are rar Na
area
l ota7. aval J. f r ami ng
Net i nsul. ater.l wal.i .r-~rt
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1nt:.a7. r:i.m :icri.st.: area 1:~';~
tic..ft---•~~t-:: f~
ar-ea
1"c,ta:l Fcn'ici
nati.on
Tot.al fcru-iclat:acan i.vind -`'~'---~.Sl.r.._F t 14------- 1.=.-4
nr.~w -
-----rt~'~__sq.
-;)`fot.a7. iRf,.!
I f i tern : i s t.lic sarne as, c:>r ess than i. i:em 1, Yot_i
ha•ee met the i.ntrnt pf MI.'f1Fi1.16006 Fl and O
Rooficeiliny cal.culat.i.r..ni
Trata:l slavl.:iyht aY"F?!d n/~ =.se {t
Tnt.al re'rcrf fr:e:i..l.:i. nci ~Fr-ami. r'iei ----.:1,='.'.~~---=>y.
Net an,i_il.atecl r-c,r.rf area
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s samFa au:;, cn• :Lr=ss than .i.'., yoi.i met tYie :irrL-ent
of 2 PILAh 1.16008 A ancl 0
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l'n urFi:l.:ize t:Pie I:.ot.al enve7.ope !syst:em mtathnd thie suun of
i}Pm5 I and 2 shall be qr-eaier- tl-ian Ylie si..im oi items
_ au'i c:l 4
7.) °F.')
= ~
+4) _
ier-eby r_.F+rt:it.fy tliat tlie bi.ii.ld:inq hf=re descr i.hecl meei:.s
rnr e,;c:ee-+cl=s the stat:.E+ r.af m'i.r'inps;ota @I'1F-!Y"gV cnnsi•-vatI.on act.
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1, IrrF,er'ior- air film ..F6H l. Int:E.ri.or ,iir film „68
i/.," 9YP. bd. ^45 2. 5'E3" gYP bd. .56
3. 5 1;2" of soft wcaacl 6.87 ' 1.;':'~~ o-v¢~nci 4..~7
4~. ~_'S!:';::'. t~ildr..i.te , ......~~?Ei 4!. ~:I.iy" .ins. 33.24
S. SSd11'1W .01.
Tot.al. Ii :'[9. t3'~
6. e;:t:er-i or-
air• film .1'7 I..1 1!R .026
l'"oi:a:1. fR 11._96
Snsi_il~ted sectinn
1. Int.er:i.or- a:ir film .68
LJ i R .92
f1 qyf:i k7d. .56
, 14" i.ngul.ation 42.00
I_nsul.ztccJ >pc.ti_nn. Tnt<+.1 R 4':. v4
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1/2" u)'p. hci. .Ad:i ~
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c~anditi..gn
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5. sidi.riq .53:1
6. e:;i_eri.or- air film ,,17
Toi:'.a1 F"i '.19
U = 1ff"t f>.,t]~i'
Ri:..m sc:r:tiur~
. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1. Interi.or ai.r- film .,f,f?
;.i :(i;," hatt ins. 19,0
1 1/2" wc:aod 1..H4
4„ 'c'S/.',ir' bi7.dr°i.te :?.r>fa .
5. si.ding .E3:1
h„ ext.er-:ior air- film .,:17
T'e7{-.'r_l1 Fi 2 4.6:=,
I.1 = 1/R .U~~
F99009tion sec.{:iori
_
i.ni_eri.or a:ir film .643
1" st_vr°ca i.ns. i;,00
. 12" conc b7.k. I_28
4. e>: l: Nr i. or- z:i. r f:i 7. m .17
T'otzl R 7.
U = .t!R
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4875
New ConatruMion ReauiremeMS RemodallReoair Reauiremenh
• 3 registereC site surveys shawing sq. k. of lot, sq. N. of house; and all raofed areas • 2 copies of qan
(20% maximum lot wverage allowed) . 1 set of Energy CalculaUOns lor heated aCditions
• 2 copies of plan showing beam 6 window s¢es; poured fouM desgn, eh.) . 7 site survey far eztenor add"Aions & decks
• 1 sel of Energy Calculations • Indiwte if home served by seDtk system for additbns
• 3 copies of Tree Preurvation Plan if lot platted aker 7l1/93
• Rim Joist Detzil Opfions selecUon sheet (bldgs with 3 or less wits)
00
DATE ~ ` (~lI62 VALUATION yZ'37-
SITE ADDRESS L1131 5tC4t~5 AV'15 MULTI-FAMILY BLDG Y ?N
TYPE OF WORK NEW PcOU 1' fIREPLACE(S) ?0 _ 1_ 2
APPUCANT T-Ar U LD 1- I~G K CCyr~~,J~ •
STREET ADDRESS3~01 ?~C:{A, I~2 1 J~/2 5• CITY mnIs STATE mn Zip 554 (32
TELEPHONE #Wa99`Q~O CELL PHONE # FAX # 0,~_7 VSY 5~213
PROPERTYOWNER f Z/bOll~i V, (cNI4-I$ TELEPHONE#
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNGSOTA RULES 7670 CA'I'EGORY 1 MINNESOT:1 RliLk:S 7672
(J su6mission type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
. Energy Envelope Caiculations Submitted
Plumbing Contractor: Phone #
Plumbing system uicludes: _ Water Softener _ Iawn Sprinkler Fee $90.00
Water Heater No. of R.I. Baths
No. of Baths
Mechanical Confractor: Phone #
Mechanical system includes: _ :1ir Conditioning Fcr. $70.00
Heat Rccovery System
Sewer/Woter Conhactor: Phone #
-
I hereby acknowledge that I have read this application, state that the i or ation i , n agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordi ces.
Signature of Applicant
._.._W_.._._•-_._-----____._.._____. ~ - ~ ~
OFFICE USE ONLY ,II11 0 9 2002 i~
Certificates of Survey Received _ Tree Preservation Plan Received _ Not quired _
BY~_~_u 4102
OFFICE USE ONLY
O 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bidg
? 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 6ct. Alt - SF
? 04 02-plex ? 10 OS-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 •Demolitfon (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 W idth
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinaUC.O.
_ Footings (deck) _ FinaVNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tes[s _ Final
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insulation _ Retaining Wall
Approved By , Building Inspector
-
Base Fee
Surcharge
Plan Review
MGES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
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L_1,Lt- B o~ ME HANICAL PERMIT RECEIPT #/G
SUBD. Ce~ (612) 681-4675 bATE / /U
RESIDENTIAL
PLEASE COMPLEI'E UPPER PORTION ONLY FOR SINGLE FAMII,Y DR'ELLINGS. ALSO, COMPLETE FOR
TOR'NHOMES/CONDOS WHEN SEPARATE PF.RMiTC Agg gEQUIRED FOR EACH DR'ELLING UNIT.
OR'NER: ~ ~.wC ~JI,Q • FEFS
STi'E ADDRESS: ADD ON/REMODEL (EJIISTIING $ 15.00
4'13 fSwes 14Ut° • CONSTRUCTION ONLl)
HVAC: 0.100 M BTIJ 24.00
INSTALLER. C,K o,~ ~(~j G• ADDITIONAL 50 M BTU 6.00
ADDRESS: GAS OU1ZEfS - MINIMUM 1 Q $3 CTl'P: ZIP: SURCHARGE: E .50
SIGNA TOTAL: S~ICOMMERCL4L
PLEASE COMPLEI'E THIS PORTION FOR ALL COMMERCIAI/INDUSTRIAL SUILDINGS. ALSO COMPLEfE FOR
APARTMENT BUILDINGS OR OTAER MiTLTI•FAhIILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR
EACH DWELLING UNIT.
WORK DESCRIPTION: CONTRACI' PRICE FEES
1'i(o OF CONTRACT FEE.
STATE SURCHARGE IS $.50 FOR EACH
$1,000 OF PERMIT FEE. $
PROCESSED PIPING - $25.00
s
MINIMUM FEE - $25.00
OR'NER: TOTAL: S
STTE ADDRESS:
TENANT:
SUITE
INSTALLER:
ADDRESS:
CITY: ZIP:
PHONE CITY SIGNATURE:
SIGNATURE
GITY OF LA4AfV FUK Gl'fY USS VNLY
3830 PILOT RNOB ROAD
. a EAGAN, ?IN 55122 PERMTT #
PHONE (612) 454-8100 RECEIPT k rb
DATE:
~FES.IL>~'!!I21`~:; PLEASE COtiPLETE UPPER PORTION ONLY FOR SINGLE FAMZLY DWELLINGS 6
TOWNHOMES/CONDOS WIiEN PERMITS ARE REQUIRED FOR EACH ONIT.
UORK DESCRIPTION COMPLETE THE FOLLOWING:
N0. FIXTURES EA. TOTAL
NEW CONST _ ADD-ON MINIMUM 15.00
ADD ON SHOWEA 3.00 ~
REPAIR WATER CLOSET 3.00 ~
~ SATH TUB 3.00 3
~ ` _ 3 LAVATORY 3.00 9°O-
OWNER NAME: V C aSO~~ f KITCHEN SINK 3.00 33.00
SITE ADDRESS: ~l/3` N11~ ~ HOT TURB/SPAY 3.00
! WATER HEATER 3.00 ~
IAT: °lo~Z BIACK -9 SUBD. -0/-- FIAOR DRAIN 3.00
GAS PIPING OUT.
INSTAI.LER: (MINIMUM - 1) 3.00 3'
ROUGH
ADDRESS: Jc~-o -Fxe~t YWJ~L - OTHER OPENINGS 1.50
r ~
~ = WATER SOFTENER 5.00
CITY: D ZIP: PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
PHONE CO
SUBTOTAL $
ya ~
ST. SURCHARGE .50
SI A OF PERMITTEE s sa
TOTAL:
~i(jMMERCIALjiNDIISTRiAL: PLEASE COMPLETE THIS PORTZON FOR ALL COP4SERCIAL/INDUSTRIAL BIIILDINGS AND
~ MULTI-FAMILY BIIILDZNGS WfiEN SEPARATE PERMITS ARE NDT REQUIRED FOR EACH
DWELLING UNIT.
CONTRACT PRICE: FEES
OWNER NAhiE: 1$ OF CONTRACT FEE.
STATE SURCHARGE - $.50 FOR
SITE ADDRESS: EACH $1,000 OF PERMIT FEE.
IAT: BIACK _ SUBD. $25.00 MINIMUM F'EE.
INSTALLER: CONTRACT PRICE x 18 $
ADDRESS: STATE SURCHARGE $
CITT: ZIP:
TOTAL: $
PHONE
(SIGNATURE)
FOR:
CITY OF EAGAN
2004 RESIDENTIAL PLUMBING PERMIT APPLICATION {7 ~"a
~ CITY OF EAGAN ~~p(S
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
Date ~ I3` 1 01-f FROBERT
4AVENUE
Site Street Address AN, MN 55123 Unit #
(651) 683-9114
Property Owner lephone # ( )
Contractor Norbt oyri P `ttmTelephone# gZ7-~p33
Address 2-905 t7arf,.ef }IY. GD. cicy state rfi hj zipowtv
The Applicant is: _ Owner _ Contractor _Other
Alterations to existing dwelling $ 50.00
_Add fixtures to rooms, excluding water softener and water heater
_Septic System Abandonment
_ Water Turnaround (add $121.00 if a 5l8" meter is required)
Other:
t_-----
Water Softener x Water Heater $ 15.00
X replacement _ additional
Lawn Irrigation System RPZ_ new _ repair _rebuild $ 30.00
State Surcharge $ 50
Total $ j550
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 with the approved plan in
the event a plan is required to be reviewed and approved.
J()ffrecf L_ Norblom a'
ApplicanYs rinted Name Ap- i nt's Signature
. p 2s
2006 RESIDENTIAL BITILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX 4 651-675-5694
NewCons6uctionReauiremenGs RemodeVReoairReauirements 3 registered ste surveys showing sq. tt. of lot, sq. R. of house; and all roofed areas 2 copies of plan showing foo6ngs, beams, joisfs
(20%maeimum bt coverage allowed) 1 set of Energy Calculations Por heated addNons
2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey Por additions & decks
lsetofEnergyCalcula6ons Adarftn-indicateilon-sfesep5csystem
3 copies of Tree Preservafion Plan if lot platted afler 711l93 '
Rim Joist Detail Options selection shcel (huildinqs with 3 a less units)
Minnegasco mechanical ventilation form
Date O / 6'La Construction Cost
Site Address UniUSte #
Description of Work Ag\au 1 oOc l.o ( i •
o
Multi-Family Bldg _ YX N V Fireplace(s) _ 0_ 1 V 2 '
Property Owuer ~l"QA_ Telephone #
THD At-Home Services, Inc.
Dba The Home Depot At-Home Services
cootractor 3200 Cobb Galleria, Suite 200
Address Atlanta, GA 30339 Cit3'
State License #20268257 - 763-542-8826 Telephone # ( )
~
{4 COMPLETE THIS AREA ONLY IF CONSTRUCTIN6 A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
• t,
Energy Code CategOry Residential VenGlation Category 1 Worksheet • New Energ'y,'Code W(Aksheet . submission type) Su6mitted . Submittetl'
• Energy Envelope Calculations Submitted ~11V . ~ry . ~i
In ihe last 12 months, has the City of Eagqn issued a permit for a similar plan based on a master;plan?;
_ Y _ N If yes, date and address of master plan:
Licensed Plumber Telephone
Mechanical Contractor Telephonel#(',
10 HJ ~Sewer/WaterContractar Telephone#(
~ J'
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 applica 'on for a permit, and work is not to start without a
pe it that the work will be in accordance with the approve lan in the case of work which requires a review and
ap val of plans.
A p icant's Printed Name Applicant's Signature
Y
DO NOT WRITE BELOW THIS LINE
Sub Tvpes
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bidg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01of_plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn.(4-seaJ ? 33 Ext.Alt-5F
? 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-plex ? 25 Miscellaneous
Work Tvpes
? 31 New - ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration - ? 37 Demolish Buiiding" ? 43 Reeoof ? 46 Windows/Doors
? 34 Replacement °Uemolition (Entire Bldg) - Give PCA handout to applicant
DeSCrID[IOfI: Wate} Damage _ Yes .
Valuation Occupancy MCES System
Plan Review 100% or 25%
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinkiered
Type of Const Width
REQLJIRED INSPECTIONS ~
_ Footings (new bldg) Sheetrock
_ Footings (deck), FinaVC.O. . . . a
_ Footings (addition)' - FinaVNo C.O. -
_ Foundation HVAC
_ Drain Tile Other
Roof _ Ice & Water _ Final _ Pool Ftgs Air/Cras 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
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
5&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
Ins#alled
;;neser.+!~'-- Stding and Windows
LIMITED POWER OF ATTORNEY
, .
,
~
COLFNTY OF COBB
STATE OF GEORGIA
KNOW ALL PEOPLE BY THESE PRESENTS:
THAT I, David N. Katz, a resident of Montgomery County, Pennsylvania
("Principal"), and a licensed contractor of ItMA F3ome Services, Inc., DBA Home '
Depot Instali_ed Sales loca+.ed at 560 Mendelssohn Aver_ue North, Go:den Valley, IVIItiT
55427, having a license number of BC- 20268257, do hereby appoint, name and
constitute Elder-7ones Building Pemut Service, Ina ("Agent") as my true and lawful
attorney-in-fact and do authorize and grant said attorney-in-fact for me and in my
- name, place and stead the power to execute, acknowledge, sign and deliver (in such
form as may be required by the municipality) a permit application, or any other
instrument(s) which may be necessary arid appropriate, in arder to obtain the proper
permit(s) from the City of Eagan, Minnesota for the installation, maintenance and
repair of windows and siding (the "Work").
The powers conveyed to the Agent by this Limited Power`of Attorriey are
limited solely to the eJCpress powers delineated herein and appty solely to the Work.
This Limi*ed Power of Attorney shall expire arid automatically be revoked on the 21st
day of May, 2004, which date is one year from the execution hereof. Further, the
powers conveyed by this Limited Power of Attorney may be revoked by Principal at
any time by express revocation and shall also be revoked by the Principal's death,
disability, incapacity or incompetence.
LTT WI'~'NF_SS WIIEREOF this Limited Po`uer ofAttoa-!iey is e.iecuted this
21st day of May, 2003
David . Katz
S WORN TO AND SUBSCRIBED BEFORE ME by David N. Katz on this
21 st day of May, 2003.
Q1
Notazy P ic in for the State o eorgia
b2y Commission Expires: January 21, 2006
396816.0
Proudly sold, furnished and installed by RMA Home Services, Ine., a Home Depot authorized contractor.
3200 Cobb Galleria Parkway, Suite 200 • Atlanfa, GA 30339 • Phone (770) 779-1300 • Fau (770) 984-0709 • Toll free (800) 79-DEPOT
~ 2007 RESIDENTIAL BUILDING PER111IT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694 C
New Coretrw.tim Reaurte~ RmrodeVReoa"v ReawremeMS EI~
3 registered sile surveYS shawin9 s9. ft M lot s9. R M Irouse; and all roofetl areat 2 copies M plan shoxin9 Wft5, beams, Jnists
(zo% mmdmm ioc wvereye aeohva) 1 set N Energy Calculations fa heated adNtlons
t So~k Repat il praposed bm'Itlinp's to Oe ptaced m d6Mirbed soll 1 siEe surveyfor edditlons 8 decks
2 copies of plm shwving beam & windox slzes; poured tound deslgn, elc. Addton • indcafe Honsife septlc sysfem
lsetofEnergyCalwlatirn5
3 copies of Tree Preserratlan Plan "rf IM pletted after 711193
Rim Jols[ Delad OpGais selecfian sheet (buildings with 3 or less urots)
Mnnegasco mechanicel verrdlatim form
Plans are considered ublic information unless ou state the are trade secret and the reason.
Date 0q / 0 z- /oq_ Construction Cos[ iJ Zi /0v'00
Site Address 4 ,S) 5~4s 43d UniUSte #
Description of Work VFP 14<t.. I I ~.?:^~VO-~S ~ OPe, i~ ~ R-~51~ ~vS.
J
Multi-Family Bldg _ Yt-K N Fireplace(s) _ 0 _ 1 _ 2
Property Owner 14 1 ri kTelephooe # (qS2 ) Z to -(S ~Y
(!~er o-4- `A145 Ct~1tido,.: j &I Cz. 2.DUlPO~2-7
Contractor
Address F6S0 C) ~e~A ~)2 - City APPP 0'~ IteY
gtate A/In) 2ip S z Telephone #(~SZ )f1rQ I-3Zf00
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672
Energy Code Category , Residenttal Ventilation Category 1 Workaheet • Naw Energy CoCe Worksheet
(J submission type) Submined Submitted
• Energy Ernelope Calculatlons Submilted
In the last 12 months, has the Ci1y of Eagan issued a permit far a similar plan based on a master plan?
_ Y _ N If yes, date and address of master plan:
Licensed Plumber Telephone )
Mechanical Coniractor Telephone )
Sewer/Water Contractor 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 approve lan in e of work which requires a review and
approval of plans. 0 l D~@ 2 n M
q,~'~oN i a
Applican s Printed Name App c Y' ature 0 7 200$
By--
DO NOT WRITE BELOW THIS LINE
Sub Types
? 30 Accessory Bldg
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool
? 02 SF Dwelling ? 08 06-plex ? 16 Fi2place O 21 Porch (3-sea.) ? 31 Ext. Att - Multi
? 03 Otof_plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn.(4-sea.) ? 33 EM.AR - SF
? pq py_plex ? 10 OB-plex ? 18 Deck 0 23 Porch (screen/gazebo/pergola) ? 36 Multi Misc.
0 OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-Plex . ? 25 Miscellaneous Work Tvoes
[3 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 AddiUon ? 38 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Atteratian ? 37 Demolish Building• ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'DemolNion (EMlre Bldg) • Olve PCA han0out W applicant
DBSCI'IDtfOfl: Water Damage _ Yes
Valuatlon Occupancy MCES System
Plan Review _ 100% or _ 25%
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Wdth
REQUII2ED INSPECTIONS
Footings (new 61dg) _ Sheetrock
Footings (deck) _ FinaUC.O.
Footings (addi6on) _ FinaUNo C.O.
Foundation _ HVAC
Drain Tile OtheT
RooF Ice & Water Final Pool Ftgs Air/Gas Tests Final
Framing _ Siding _ Stucco Lath _ Stone Lath _Brick
Fireplace R.I. AirTest Final Windows
Insulati-n _ Retaining Wafl
Approved By: , Building Inspector
Base Fee ~ y ^
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Pemiit 8 Surcharge
Treatmern PIaM
License Search
Copies
Other
Total
Use BLUE or BLACK Ink
For n yn I Office Use
City 1 1j j1~n Permit 1 Q -a ( Q
of i ;a 1
3830 Pilot Knob Road I Permit Fee: I
Eagan MN 55122 1 I
Phone: (651) 675-5675 Date Received:
Fax: (651) 675-5694 1 I
I Staff: I
L----- -----------I
2013 MECHANICAL PERMIT APPLICATION
❑ Please submit two (2) sets of plans with all commercial applications.
Date: Site Address: A I S1 %~Myl
Tenant: Li-l"111--k / Suite
Residen l.~ Name:s l _50.6 Lh~~k Phone: (6<-j T
caner
Address / City / Zip: \"7+J
2 9
Name: License A&S 1 f r~~
Contractor Address: Z- ;~a r i cC City:
State: 4~41 Zip: /A Phone: Y~l Z~ 5 >J
Contact: Email: Y ' Jai
New Replacement Additional Alteration Demolition
Type of Work Description of work:
NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City
Code. Please contact the Mechanical Inspector for information on permitted screening methods.
RESIDENTIAL COMMERCIAL
P /Furnace - New Construction Interior Improvement
Permit Type YAir Conditioner Install Piping Processed
-
_ Air Exchanger Gas Exterior HVAC Unit
Heat Pump _ Under / Above ground Tank L- Install / - Remove)
Other
RESIDENTIAL FEES:
$60.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge)
$100.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) = $ TOTAL FEE
COMMERCIAL FEES:
$75.00 Underground tank installation/removal (includes $5.00 State Surcharge) OR Contract Value $ x 1%
$60.00 Minimum (includes State Surcharge) = $ Permit Fee
t If the project valuation is over $1 million, please call for Surcharge = $ 5.00 Surcharge"
= $ TOTAL FEE
CALL BEFORE YOU DIG. Call Gopher State One Call 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.gopherstateonecall.org
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 underst d 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 a pr ed in the case of work which requires a review and approval of plans.
x x
Applicant's Printed Name Applicant's Signature
-FOR OFFICE USE
Required Inspections: Reviewed By: Date:
Underground Rough In Air Test Gas Service Test In-floor Heat Final HVAC Screening
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA126129
Date Issued:08/14/2014
Permit Category:ePermit
Site Address: 4131 States Ave
Lot:22 Block: 2 Addition: Stafford Place
PID:10-72500-02-220
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 .
Derek Huntziger
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 -
Janet M Marek
4131 States Ave
Eagan MN 55123--159
(952) 210-1574
Prescription Builders
1123 Drew Dr
Woodbury MN 55129
(651) 503-3467
Applicant/Permitee: Signature Issued By: Signature