2246 Whispering TrJun 0611 02:31 p Allen Hambleton
4,111 CityofEa�all
Date:
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
2011 RESIDENTIAL BUILDING PERMIT APPLICA
6_6.-11 Site Address: 0)o2LJ1, 1#1./ •+3 er;'�5 T .
JUN 6 2011
651-528-8358 p.1
Use BLUE or BLACK Ink
A (.1- -Ft512-. LREt)CT-
£4 A,CI A/04.867-1
For Office Us$.,,,
Permit #:
Permit Fee:
Date Recived:.6- A/1/
Staff:
ON
RESIDENT!
OWNER
TYPE OF WORK
Name: rn 6�,-t2- c-LQL,40J
k.
Address ! City / Zip: 9gL14, t 'e o,5' f r. ter g�f/f
Unit#:
Phone:
Applicant is: Owner Contractor
(-‘_4e. f44
Description of work: r. et; Gt
Construction Cost760 *1'c'
.e..sc',071-1
Multi -Family Building: (Yes ! No j'C )
CONTRACTOR
Company: A v-cr..e., gets -e441/41
Lr S r} L✓.
State: .3-7 o).4 Phone: �.�% - $ — U Qz sc
License #: 366 3L1 036 Lead Certificate #: Atom- L1 9 33 3'I
Address:
4:Le t' asg t`a
�,.
Contact
City:
`ho <Le ,r7eall
1—
If the project is exempt from lead certification, please +explain why: (see Page 3 for additional information)
Vita itit e-- t S pac4 1 17g
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit fora similar pian based on a master plan?
Yes No if yes, date and address of master plan:
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 maybe 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. CaII Gopher State One Call at (651) 454-0002 for protection against underground utility damage.
CaII 48 hours before you intend to dig to receive locates of underground utilities. vvww oorDherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work wilt 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 inthecase of work which requires a review and approval of plans.
X ,4//m 4# !4j
Applicant's Printed Name
x,
Applicant's Signature
Page 1 of 3`
SEWER & WATER PERMIT OFFICE USE ONLY
CITY OF EAGAN
~ PERMIT DATE 12 L " ~ 3830 PIIOt K110b Rd. WATER PERMIT ? I!(; SEWER PERMIT #
P.O. Box 21199 METEq #~,35/30 r~ B.P. RECEIPT ~•FF;7~
Eagan, MN 55121 ' e2l B.P. RECEIPT DATE
METER SIZE
iSSUE bATE ~ U PRV - BOOSTER PUMP
~ SITE ADDRESS h~`~ ?'t r'.' r PEAMlT REQUESTED
' LOT R BLdCK _ SEC/SUB ~ t S~rfyK
APPLICANT: G?QSttt v CZ c0fi.} SEWER ~ WATER - TAPS
ADDRESS: Sf .
- COMM/IND ~ RESIDENTIAL
CITY, STATE - I-t ' ra i r N Zip SS Ja -1- `
PHONE: ' i Z. ~i _X NEW _ EXISTING
PWMSEA: ~J^[A [L ~ k um~•J ~ r. I:-,
ADDRESS: 1 ('-2 k~ M.,oon<) SOr??^ 7c v' YY.4 I AGREE 70 COMPLY WITH CITY OF
CITY, STA7E ~i L), n'> 17"- ZIp ~--Z<-% EAGAN ORDINANCES:
PHONE: 4• i 9 •
OWNER: vN ic- O
ADDRESS: Ftnig_ 42- TY, STATE SIGNATURE WHEN METER ISSIlED
, V
G - ZIP
PHOME: W--7
j PLEASE ALLOW TWO WORKING DAYS FOR PRqCESSING. FOR STORM SEWER PERMITS, CONTACT
~ ENGINEERING DEPT. - ' - . - " _
.:`~EA„r'TIVA7~ -pI;AN°?~V1JL~b 6/27f90 ~
894-5746 CITY OF EAGAN 17347
_
7~3830 Pilot Knob RC~ ' - - - - • j - ' ' - - -
BUIL4INEPERMIf~ 1::..
To be used tor SF DWG/GAR Est. Value $140,000 Date IZOV 30 , 1989
Site Address 2246 ilHISPERIAiG TR
Lot I_ BIOCk 4 Sec/Sub.~ISPERINC iiQDDS OFFICE USE ONLY
PatCel No. 4TH Occupancy R-3 b"1 FEES
Zoning R-i W Name `CnLLEGE CI'CY CON&TRiJG"fTOPI (Actual)Const d-m Bldg.Permit 780000
~ Address' 61970 1 S13'F ST (Allowable) V-N
° City APPLE VALLEY Phone 431-1211 # or Stories Surcharge 70•00
Length 661 Plan Review 390.00
~a Name SAME oepm 36' snc, city 100000
~i Address / S.F. Total _ ~ts~~
~C SAC, MCWCC
City Phone S.F. Footprints -
On Site Sewage - Water Conn S$0 • QO
~
uName a, site weii
Fw W - Water Meler 90•00
AddfeSS MWCC Sysiem ~.oo
<w Cjty Phone City Waler xx Accl. Deposit
PRV Requir~ ~ SIW Permit ~0~~
I hereby acknowlege Ihat ! have read this application and siale that the 8mster Pump - S/W Surcharge 1•00
inlormation is correcl and agree to comply with all applicable State of
Minnesota Statutes aruJ Cit~of Qagan Or~JirtaTtices. Treatment PI 228•00
~T"=i
Signature of Permit ee APPROVALS
~ Road Unit W•oo
A 8uilding Permit is issued to: COW.EGE CITY CONST Planner - Park Ded.
on the express condition that all wwk shall be done in accordance with all Council
applicable State of Minnesota Statutes and City of Eagan Ordinances. gidy, pry. _ Copies
Building Official _ Variance - T~TAL 3,204'00
' Permit No. Permit Holder Dale Telephone #
~ WATER X-0
SEWER
PLUMBING
H.VA.C.
ELECTRIC G% 7Q + e, 7~ / ~Cl~Gy
Mspection Qate Insp. Comments
footings I
Fourdation
Framing
Ftoofing
Rou9h Pib9.
Fiagh Htg. - v
Isul. ~ dT C.O_/?, ! ~ - C
Fireplace ~3 p e
Final Htg.
F,~l Plbg
Consl. Meter Plbg. Inspector - Notify Plumber
Engr.lPlan
Bklg. Final '~~71 j 1G~
oed Fts. ~ waS h It,r
Deck F,nM
well
Pr. Disp.
r n~. ..1 r Q. ~ ° ~r.sl~ • ''Yr'r . , NC, q.. . . . . . , . .s. _
, i:i. .M,j, ~ ' . . . . . . . . . . . . . . _
PLUMBING PERMIT For Office Use/Or~y
CITY OF EAGAN PERMIT #
CONTRACT 3830 pILOT KNOB ROAD, EAGAN, MN 55122 RECEIPT # , , 7~
PRICE PHONE 4548100 DATE:
l 1 ~el" ~ i"~ 1•
Site Address BLDG. TyPfi~ WORK bE$CRIPTION
~ f
Lot Block tSec/Sub. Res. ~ New ?
r. Muh. Add-on
lt i 1 ~ 4J l i;. Comm. Repair
Name Other
~ Address t;~ ~ ~
e City 'Phone RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
; L FIXTURES T .Tl
77 'jtA. Water Closet -$3.00 $ C i.
Name ~ Bath Tubs - $3.00
- Ll Address Lavatory,- $3A0 ~CRy ~ C V~ 1 ieT Phone Shower -$3.Q0 -
Kitchen Sink - $3.00
UrinaUBidet - $3.00 7_
FEE3 T_ Laundry Tray - $3.00 _
COMM./1ND. FEE -1% OF CONTRACT FEE ~ Floor Drains -$1.50 1 b
' APT. BLDGS. - COMM. RATE APPLtES ~ Water Heater -$1.50 ~--777-
TOWNHOUSE & CONDO - RES. RATE APLLIES Whirtpool -$3.00
MINIMUM - RESIDENTIAL FEE $12.00 -r Gas Piping Oudets -$1.50 f-> >
MINIMUM - COMM.IND./FEE $20.00 (MINIMUM • 1 PER PERMIT)
STATE SU HARGE PER PERMIT .50 Softener -$5.00
(ADD $.50 C P R EACH $1,000 OF PERMIT FEE) Weil -$10.00
Private Disp. - $10.00
Rou9h Openings - $1.50 -
SIGNATURE OF PERMfITEE PERMIT FEE: .
STATES S/C: ' 5Q
FOR: CITY OF EAGAN GRAND TOTAL:
PERMIT #
• • MECHANICAL PERMIT RECEIPT #
CITY OF EAGAN
3630 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
CONTRACT PRICE PHONE: +54•8100 For Office Use Only:
SiteAddress ,)t'0, BLDG.TYPE WORKDESCRIPTION
Lot,..;_ Block Sec/Sub ! Res. New x
Mult Add-on
Name
m Comm. Repair
Address
c City r~ ~ Phone~- Other
, FEES
Name ~ ~y ~ T - ~J'. RES. HVAC 0-100 M BTU - 524.00
c~ Address ADDITIONAL 50 M BTU - 6.00
3 I i . (RES. NVAC INCLUDES A/C ON NEW
p City L+T i Phone t i CONSTRUCTION)
` GAS OUTLETS (MINIMUM - 1 PER PERMIT) - 1.50 EA.
TYPE OF WORK COMM/IND FEE - 1% OF CONTRACT FEE
Forced Air j M BTU APT. BLDGS. - COMM. RA7E APPLIES
TOWNHOUSE 8 CONDOS - RES. RATE APPLIES
Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
Unit Heater M BTU HEMODELS - 12.00
Air Cond. M BTU MINIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
Vent CFM (ADD a•50 S/C tF PERMIT PRICE GOES
Gas Piping Outlets N ~ BEYOND $1,000)
Other - `
FEE
SIGNATURE OF PERMITTEE
S/C:
TOTAL• `2 L''' FOR: CITY OF EAGAN
p ~ r AWMBING ER~lIIT Far Office Uae On1y
CITY OF EAGAN PERMIT*.,./_4~,'~c2
~ CONTRACT 3830 PILOT KNOB ROAD, EAGAN, MN 55122 RECEIPT# L.- - L' L w
PRICE PHONE 4548100 DATE: ~ v
Site Address 6 W i r~ r. ,r' BLDG. TYPE WORK DESCRIPTION
' Lot Blodc µ S ub Re8. x New
Mult. Add-on X
Name Comm. Repair
~ Address „ . r- Other
c City Phone S7 RE3. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
Name ) Water Cioset - $3.00 a
Bath Tubs - $3.00
~ Address Lavatory - $3.00
~ City Phone Shower - $3.00
Kitchen Sink - $3.00
UrinaUBidet - $3.00
FEES Laundry Tray - $3.00
COMM./IND. FEE - 1Y.OF CONTRACT FEE Floor Drains -$1.50
- APT. BIDGS. - CAMM. RATE APPLIES Water Heater - $1.50
TOWNHOUSE 3 CONDO - FiES. RATE APLUES Whirlpool - $3.00
MINIMUM - RESIDENTIAL FEE $12.00 Gas Piping Outlets -$1.50
MINIMUM - COMM.IND./FEE $20.00 (MINIMUAA -1 PER PERMIT)
STATE SURCHARGE PER PERMIT .50 So}tener -$5.00
(ADD a.50 SJC PER EACH E1,000 OF PERMIT FEE) WeN - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
U. G. Sprinkler System -$12.00
~~~~AE ~ ~AM~EE PERMlT FEE:
STATES SlC:
FOR: CITY OF EAGAN jp 4-"t-
.
GRAND TOTAL:
• CITY OF EAGAN N2 17347
' 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT Receipt s C. UM-
7obeusedfor SF DWG/GAR Est. Value $140,000 Date NOV 30 , 1 g89
Site Address 2246 WHISPERING TR
Lol I_ Block 4 Sec/Sub. WHISPERING WOODS OFFICE USE ONLY
Parcel No. 4EH ocaPancy R-3 M-1 FEFS
Zoning R-1
w Name COLLEGE CITY CONSTRUCTION (ACtual) Consl V-N Bldg Pcrmn 780.00
; Address 6970 151ST ST (Allowa0le)
o V-N Surcharge 70.00
Cily APPLE VALLEY Phone 431-1211 a oi srories _
Lengih 66' Plan Review 390.00
o Name SAME DeOth 36' snc, city 100.00
i~
~a AddreSS S.F.TOtal _
~ Clfy Phone S.F.Foolprinls _ SAC,MCWCC 575.00
IN On Site Sowage _ Waler Conn 5$O. 0Name On Ste Well - Watar Meter 90.00
Address Mwcc system _XX_
Acc1. Deposit 30.0City Phone aiy waier _XX_
~
PRV Reqmred _XX_ S!W Permii 20.0
I hereby acknowlege that I have read ihis application and siate Ihat the Boosier Pump - S/W Surcnarge 1.00
information is correct an agrea to comply wRh all applicable State of
Minnesota Statmes an Crt ol an Or ces. 228.00
~ Treatment PI
SignaWre ol Permite V ~"~-ti"ti~ APPROVALS
RoaO Unit 340. 00
A Bmlding Permit is i55ued to: COLT F. f TY ('ONST Planner - Park Ded.
on Ihe express condition ihat all work shall be done in accortlance with all Counal
applicable State of Mmnesola SlaWtes and Gty ol Eagan Ortlmances. Bldg. Olf. Copios
Butltling Official Lh19 OL Vanance - TOTAL 3,204.00
V
~~r#ifir~te uf (1~rru~~cnr~ ~
Citp of Cagan
Eepttrtmrtti nf gixilDing 3nspertim
• This Certificate issued pursuant !o the requiremenu of Section,306 of the Unijorm Building ~
; Code certifyrng that ai the time of issuance thu struclure was in compliance with 7he vanous ordinances of !he City regulating buildirsg construction or use. For the jollowing:
Uu ec. n.T~.AR Blde Pormn No 1734~7
Qazsdi`amn .Jw /Pl ~ OsuWnryTyce ttl0 I loni^6Us[ricl Ri TypeCOntt VN
OwnerofBuildiq aWTYM ~v CMM- Addreu 697l1 IS1CT CT APWE VATTF'S'
Buddmg Addoeu 221~6 SJHI°PfT~ ~iq T I, B4, MiTSPPRTN: 4KYA]S 4'rt7
f
4 l n~,, p,~ MAlN17 7~ IQQfI
. ' ~ BmldinH Officii w
Rp$T IN A CONSPICUOUS PLACE
\
2005 RESIDENTIAL BUILDING PERNIIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construdion Reauirements RemodeVReoair Reauiremenls Offx:e Use Onlv
3 registered site suneys showirig sq. ft. o( lot sq. fl of house, and all roofed areas 2 copies ol plan Cert of Survey Recd _ Y_ N
(20°h mazimum lot coverage allawed) 1 set of Energy Calculations for heated additions Tree Pres Plan Reod _Y _ N,
2 copies of plan showing beam 8 wintlow sizes; poured found design, etc. 1 stte survey foradditions 8 decks Tree Pres Required _Y _ N
lsetofEnergyCalculations Atldrtwn - indicafeilon-sdesepficsystem On-sileSepticSystem _Y _N
3 copies of Tree Preservation Plan'rf lot platted after 711/93
Rim Jo'st Defail Options selecfion sheet (buildiys with 3 or less unRs)
Date 7_ Construction Cost M/.Y~
f
Site Address Unit/Sre €1
Description otR'ork wv/~~~~~/~ /WzIr
Multi-Family Bldg _ YN Fireplace(s) _ 0_X 1 _ 2
Property Owner Telephone # (~~f --7
Contractor
~
Address City,
State 1~ Zip L Telephone # (do
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category . Residenlial Ventilation Category 1 Worksheet • New Energy Code Worksheet
(V submissionlype) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber Telephone )
Mechanical Contractor 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 staR 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.
t' ~
Applicant's Printed Name 670 Applicant's Signature
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OB 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 Eut. Alt - SF
? 04 02-plex ? 10 OB-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 1 D-plex ? 19 Lower Level ? 24 Stortn Damage
? 06 04-plex ? 12 12-plex PI6g_Y or _ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement O 38 Demolish Interior ? 44 Siding
O 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building` ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Oemolition (Entlre Bldg) - Glve PCA handout to applicant
Valuation Occupancy MCES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bidgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinaVC.O.
_ Footings (deck) _ FinaUNo C.O.
_ Footings (addition) _ Plumbing
Foundation H V AC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests Final
_ Framing _ Siding _ Stucco _ Stone _ 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
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
jod 2oos RESIDENTlAL PLU~lIBING PERr~niraPPUCaTioN CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Plzase compiete -lor modifications to existing r=sideniial dwellinas
Date I I ~
Site Street Address Z Unit #
I
Property Owner ( f'~mG ~ ~j--!/V0 W tql~ Telephone# ( )
Contractor ST 'f'q~ ~ ~ILI ( 6 0 rn Telephone a (0,5f )
Address ~It~ md P ty Statea& Zip
The Applicant is: _ Owner L,-~ontractor _Other
Septic System Naw _ Refurbish2d Submit 2 sets of plans and MPC Iicense Includes County fee
- $ 100.00
P2r as-buiit S 10.00
i
Alterations to existing dwelling S 50.00
_ Add plumbing iixiures. This fee includes insiallation of a water sofiener an6ror watzr
nea-,er a't the same Um°. !f you are installing onl a wafer softener and/or water
heater, do not cornplete ihis section; meve to tne n=xt section and ch=ck the
appliance(s) you are installing.
_S2ptic Sys?2m Abandonment
~ _Water Turnaround (add $130.00 ii a 5/8" meter is required)
Other:
-
I Water Softener ater Hea'.er S 15,00
_ new feplacement
Lawn Irrigation _RPZ _PVB _new _repair _rebuild S 30.00
i
State Surcharge S 50
~
Total S
so
I hFreby apply for a Residential Plumbing Permit and acknowledge that the information is complete and accurale; tnat the
work will be in conformance with 'he ordinances and codes of the City of Eagan and the plumbino codes; that I
understand this is not a permit, but only 2n application i'or a permit, work is not to stzrt without a permiS 2nd work will be in
accordance with the aoproved plan in the event a plan is requi be review=d and aoproved.
App!icanYs rinted Name cant' igr2fure
A
2006 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX 4 651-675-5694
New Construction Reamremenis RemodeVReoair Requiremenis OK&~'U'se Onl'v
3 registered site surveys showing sq. ft of lot, sq. ft. of house; and all roofed areas 2 wpies of plan showing foohngs, beams, joisis Cer~ of Suiye"y,Recda Y'==N
20%maximumlotwver eallowed 15etofEne Calculationsforheatedadditlons Soils'RePo=`~
( a9 ) ~9Y _du;d-'<;: 3- -.Y
1 Soils Repod if pmposed buiiding is to be placed on disWrbed soil 1 site survey for additions 8 decks Tree Pres PIan~Recd-.~x N
2 copies of plan showing beam 8 window sizes; poured found design, etc. Addifion -indicate ilon-sife septicsystem Tfee Pres Requlred: YN
1 set of Energy Calculations On-site„_Seplic System,~~„;'_Y N
3 copies of Tree Preservation Plan if lot platted after 711793 ~
Rim Joist Dehail Oplions selecGOn sheet (buildirgs with 3 or less units)
Minnegasco mechanical ventilation form
Date VI, / 1 0 / flU 1 Construction Cost 16 NW?
SiteAddress 35~0 W1~~~,J Wp('') Unit/Ste #
Description of Work \N,)T''1 w (sf~~ ~N~l,y-j 1 1T U~" :7J OD a1J )
Mul[i-Family Bldg _ Y~ N Fireplace(s) _ 0 ~ 1 _ 2
PropertyOwner _R\C~. ~jkf+-1~;~ Telephone#(6') )uD.)-1133
eert
dba ~ireside Mesltll i
Contractor License 20512OB0
Address City
State Zip Telephone )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category . Residential Ventlla[ion Category 1 Worksheet . New Energy Code Worksheet
(J submission type) Submitted Su6mftted
. . Energy Envelope Calculafions 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 Telephone # ( J
Ls
Mechanical Contractor ~ Telephone )
unu
~ 1 200~
Sewer/Water Contractor DEC 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 pl in the case f work which requires a review and
approval ofplans.
~JA 1A ` U1 yW1,, .
Applicant's Printed Naine Applic 's Signature.
DO NOT WRITE BELOW THIS LINE
Sub TVpes
? 01 Foundation ? 07 OS-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
O 03 01 of _ piex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 EM. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo/perola) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 LowerLevel ? 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 Building` ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolition (Entire Bldg) - Give PCA handout to applicant
DesCriptiOn: WaterDamage_Yes
Valuation Occupancy MCES System
Plan Review 100% or 25%
Census Code Zoning City Water
SAC Units Stories ~~aw"wPhump,, ,H
# of Units Sq. Ft. a=H ~ oikV„ ~
4u08t2P., 0. J:J
# af Bldgs Length V"W10
Type of Const Width
REQUIREDINSPECTIONS
_ Footings(new bldg) _ Sheetrock
_ Footings (deck) _ FinaUC.O. '
_ Footings (addition) _ FinaUNo C.O. '
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool Ftgs Au/Gas Tests Fina]
Framing _ Siding _ S[ucco Lath _ Stone La[h _Brick
_ Fueplace _ R.I. _ Air Tes[ _ Final _ Windows
_ Insulation _ Retaining Wall
Approved By: , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
1989 HIIILDIBG PENHIT APPLICEYIOR
CITY OF EAGAN
f 913 it
SIIiGLE FAMILY DiIELLIBGS lDLTIPLE DWELLINGS COlR4ERCIAL
2 3EfS OF PL?NS 2 9BTS OF PL?NS 2 3ETS OF lRCBI?ECTURLL
3 SEGISTERED SITE SIIR4EZS BEGISSSRED 3IT6 3U8YEIS - i 3T6DCf9R1L PLENS
1 SET OF EREAGY CALCS. (CHECS iTlTH HLDG DIV.) 1 SET OF SPECIPICATIONS
1 SET OF EHEBGT C?LCS. 1 SET OF EREAGS CALC3.
MULTIPLE DWELLINCS AENfiL D6ITS FOH SILE 06ITS i OF 0lfITS
aOTEt iDDAESSES F09 COAIQEA LOTS - CONTRACTOR/HOMEOSiNER MOSi DFSIGIiATE flHICH 1DDHFSS
IS DESIRED. HO CBAtiGFS UIILL BE ILLOftED OACE HDII.DIIiG PEAlSIT 13 ISSIIED..
SEi1ER 8 iiATER PEAMIT FEES lPD 1CCOIINT DEPOSIT T68S i1II.L Bfi IRCLODED YITB THE BOILDINO
PEMfIT FEE. PAOCFSSING TIIM FOR SEWEA lAD 1fATEA PENNI75 IS SiiO DAYS OPCE l PERHIT 81S
HEEN COMPLETED INDICATIRG A LICENSED PLOlBER.
PENALT7E 6Pr^:.IES HHENt PERMIT IS NOT PAZD FOR IN SAME MONTB IT IS REQUESTED.
LOT CH6NGE IS REQUESTED ONCE PEHMIT IS ISSUED.
NOV i E 1989
To Be Used For: 'Sr !j2, f~1'rt~ I4 - Valuation~ ~t96 --oA Date:
Site Address Z2¢L t,AAtSpeYir ifp~l iOFFICE OSS ONLT
~ I yoj 00 0
Lot 1 Bloek Occupaney FEFS
Zoning R-)
Pareel/sub 4~hts(k v'io~ W04S 4MJZ Actual Const v. N Bldg. PermiL 780.00
1nn Alloxable V.rl Surcharge O.Do
Ovner J 6 l1vk ~ I 1 1 K,1e i of stories Plan Aeviev 0100
' Length 0 - SAC, City I cD,oc7 -
Address S ECt~1~ Depth 3(,, SAC, NWCC 5r7 5'~
S.F. Total Water Conn SD,o 0
City/Zip CodernO~AcA ,MKj S531oQ- Footprint S.F. Aater Meter 90,00
Acet. Deposit 30,00
Phone 4'1 a- u(o(o~1 On aite eexage S/W Permit 10' 00
, On aite well S/ii Surcharge 11oo
Contractor Ci)lle~e. Ci- nV15I yl/IfIc)YI l1WCC System v Treatment Pl. ZZS.oa
City vater ? Aoad Onit 3'-IO.oo
Address ~iq ~O PHV required Park Ded.
Booster Pump _ Copies
City/Zip Code Aoplp (/b/l¢~4 SS134- sUBTDTAL
lPYROYALS Penaltq
Phone Planaer _ TOTAL
Counetl
Arch./Engr. Bldg. Off. ~IIrZ9
Variance
lddress '
City/21p Code
Phone a
vALUaT~OK3 . .
.
ZZ X ZZ.. - -4'
- 6~~'{ '
20x12= ZUo
~244 x 15= /0$60
lp~smr,
r(Ox14= zz~i
31 x z7 = 83r~
1085 Xly : 1 Slg~,
ls-r FL oo,z
65mT _ 108 S
Z X 7 = 19
to
~
09 xs"b= s54So
Pp,~ t4
16x?c.F 2y xyo= 89bo
ZNo F~oorL
4 ~ x lsYz Z~
II'~c x 14/L. - 1(ob
~1as xSo-'~q_=
l 39~-7I0
~
2422 Entciprise Drive
PIONEEF! Mendota fieights, MN 55120
* * * Ir-
* eng* eering.. (siz) 681-1914
I
Certiticate of Survey ?or: COL L EV E CI TY C0A1S7: _
/
/ NORtN
j~ ~QinIG 6TrrA iL
n/.89o53,4L•w 3~1
69.40
i' 4 0 -
.
~G~ i~ ~o• ~ 161 t^ n ln
C) / v ~ ~ N
1," b o 1, ~
0
° 30
\V
i~
/ ~ • tio,~'l
Vv ° I O
L
` h - ~
\ 4z q,~ ~ 85 B/• s8i1 ~ ~ o
~
~l~ ~~N?,
~
B~~__~~r-_~_~° _
llate I~f~15 p ~ I~Q W
EAGAN EZVGINEERIIUG EP'T P.R.V. WQl~JEDD
. soo.o Denvfes exisfino Elevalion „eRg~SEVU E LEV47ION
Denofes propdfied E/evafi'ari ~owes~Floor neva on_ 864,a
- -Upnofes Uraina e~ Ufiliy Easemenl- Top o; ~lock Elevafivn ~72•0
Uenofes Orainc~e [1ow Qrraws Cv e S/ab f/evation 8ay. o
0 Denotes monumenf o Dena es Ort sef Nub
Bearlnjs shown ore assumed Su~'ec'I tU Easeinen1s ol"Rpcord
LOT 1, BLOCk" 4,WNI5Pta1NG IMOOdS TNlRD QDD.
o~uorA covNTy -
1 here ~y cerNfy thet th~s h n t ua nnd correct represenlatian of e survey of the boundaries of the ahwe .zr.iibod land, nnd of ihe location ~olpell
buildingf, thereon, ead BlI vlsVble encroachmenu, I( eny, from or on aald lend. AS surveyed by me thisday of AI/ A.D. 19QL,
Sc0 1Re I/ _ 4 O/ee p 1- Rt1RERI R,SIKICH I_S REr. NO. 4891
Z!6 g~ 1 2 ~ -
~ E`'.R10R ~P""LOPE AVERAGE "U" C0P" ITAT10N
061NER
SITE Ao0RE55 LC-.)T 4E t-OC K y INHIS'f'~I~1NC-~ WonDS 4,DVJ~.J
J ~ ~ ,
CONTRACTOR L.a«_r-c,T GlTY ~nNir DATE PHONE
~r0etermine working square footage of each.
l. Total exposed wall area Z~psj- sq. ft. x,11_, = zzo.
.2. Total roof/ceiling arca IR"70 sq. ft. x,OZIv
•Total exposed wall area above flour =
a. Total wall window area............................ Z Z 3
b. Total door area
e. Total sliding glass door area O
d. Total fireplace wall area........................ o
• e. Total Wall framing area (averagel0%).............
1'1 O
f. Total net wall area a6ove floor 12 bo ~u.~•
g. Total rim joist area 1q Z.
Total' eicposed foundation area = (04
h. Total foundation window-area o
1. Toal net foundatlon area above grade 10 4-
Oetermine "U" value of each wail segment.
~
a. 'ZZ.3 X ~"U° .~d(A = '7 7. (
~o
.
b• s`Jp X "u" .IZ,6 = 7,Q4-
C. C~ ~x NU~l C) a C)
d. ~ X ltuil
e. 1-70 z"u° oqZ R 64-
f. ( 21e-, 0 X1-U"
g. l~i 2 x„ul. oA-I = 7. 87
x„U„ ' a = C)
0A-- X "U"
3 .....................................Tota1
If item 03 is the same as, or less tlian item #l, you iave met tlie intent
of 5¢C 6006(c)2.
r
, . r
Total..exposed roof/ceil ing area = 18.e .
J. Total skyliglit area.....:....................:.. O
k. Total roof/ceiltng framing arca (average lOX)... f7g
7. Total net.insulated rooF/celling area..:........
petermine `U" value for each roof/ceiling segment.
J. 0 XOull
L• 1~ V A NV
I111 oT
~ 1
~ 2 ~
X"U"
4 . .........................Total
~If total of #4 9s the same as, or less than :2, you have met the intent of
SLC GOOu(c)l.
' Alternate Building Envelope Design
To utilize the total envelope system method, the values established by the'
sum of ltems 13 and 64 shall not be greater than the sum of items ;l and 92.
" 1. + 2_ ~ .
3. + 4. _
' . ,~?-AND rU.~. . ~/ALU.' ANAL.YZkS OF ~ ~SEI~iNG .5~c.i ~vv~
. . ` ~d
Jo,sT/ FV,,f-,itoc, AQE., .
•R•. va Lu E
.(0( INTRioR niR r?LM
4- -31- 3/L gaPrwooo
ryGYP5•1M N/ALLboAQC)
. • _ •'1-I NTER ioa. AIjt F16M
TO T~1 L" ?ALU..E
i.4.~ c i / a..~~ ¦ ~ ~ - / - 'L--`~~ '
'Z7:73~ ToTI.I. Fa°r~Ga
~NSLLl.A7E'~ ARLA S~7WGtN TNF. TOlSTS
•R- -
IIUTERiOQ AiR RILM
. ~ bc~,'w~NSU.GATioN CR•~'~
-4E: C,yPSUm wAL-L 00440
• VAPa2 OaRRIL2.
~ I + INTEK)OR AIfC IrItM
45~3&roTA L vaLu.&
I / l-S. 3L-7 = u L-~-
10TA6 Foorn4r•
pnrp7 ~~iyNrn~
-10U4 lb ti ~o/nhb R.
' K AND l.L VALUt' ANALYS IS OF LYqI.L SECT roNS
Srun / F)<AM INq ARrL mc\ ~ -
Fj... ~~LLLe
, ._bt-rNreKiLoK a,R FL~j
~S~ ~Z,GVO.Sf1M WAI.~BDA(i0
l; I !p•a S~Sorrvvooo
I Z.O(G+ 7-SHE~TN~N4
•
I ,p '
5 1o i u c, 7z.
• ~ ' VAFtDe bAQ2J"
.t wrcA109, AI+c r,LM
~3 -iorAL-' R~; I/nLuIL
Xt ~
TorAL roorAac 1-7C
INSU.LATE-o l1RCA B&TWLit W STLA OS
°i2" - vALu. c.
4Yps"m y,/AL#..6oqe0
Iq.C! (o" Iusu.L„r lo•r (R,t9 )
Z.ofn ~ S11L~?N 1 H4 •~vr c.rt24 iIE-:
.l~l AP sio~uq ~Ld
. ^ 1/APO 1f. f;yA mLtii[ d„
c RraR. iqlt AIn. rit-M
7-2 f&rDf p L Wwi, VALLAL-
' r ,T n,4'TT .
rr~•
TOTAL rootAC,p- I Zi~'O
N Li io/y7V fti
~Ar<: V~~~GucO_ ~ v
k",ANOvaL u~ Atv.4L ys':a- p, w<\Lr SLGTiOA/$
R~M So~ST qX L A:
V~L uE
•~1~._I ~1tElL102 AI2 -IL M
(q.o_-L.~-?usuL Ar~oN
~ Z.Oh 7~2-SHcAriNC~
" _ • l~'! %
__~~CTf iz. io R,q lic. f14- on
T O T A L~
~~j?•4!-t.LL
/a.z ~ ~ 24-• ~ - . ~ a
/
roTn6 ?OO rAc,L (9 Z~
FDUn1 D q-r ION \,NIqLL. AREn (ASovr. C;RAorL-.D
R,, vA L u. E.
IMrER102 AfFZ hL-r1
~I~~ S•~ ~oF a r 1-c pc.ocJc.
RIIII I.0 O ~ 404-f==&t CN.~~LN f n,( (R• (I ~
` t 7 -EXTLY 10P, AIR Ffl-M
12 •L3 'TOTAL JqLu.E-
TO7AL FmT^t.E 1 E
raan c-i 10#06it DAtt •~"3U •~~~~,~,co _
~
, . NJD ~.C VALUE AIJA~1'S15 Of ,L ~7RS `~O C+LAZEQ }~jti'~f~~
VylNDow ~IREa : TYP~ oF l~/~N~ow:
jNe ~.v~NOO~u vurrs ~./~+C gtC~/ T~SriG FO¢ "!Q -VA~µi~ TNIY ~cc na ~~s~cD
ABoJC q4~ M4y/ Ol .t~si4MEO A O[.e/!~N ~1~~G) Vw~~tL of ~R s Z'~^~
iac~u~~~~ a~2 F~~MS.
~~'~~RS~ ' 1! - -
foar.~~~.z~~ ~-foerncr - zz.~j
~OUNpAT 101J ~IlNDOW AR,FA: T)'PE oF Iti~ir/DOW :
TN6 vv~Nao~ U~~rs/a~~E, gGS~,/ rESTGDFo2'R= VK,.•c~TNLYAa~as ~~rico A~v~ wu~
M4Y er AsliyN~u P p~s~yr1 [3~at) V,a~.uc o~ •!Z'•Y IVC44OIN4
A~.4 Fi~?~e ,
1,~q1= I/~q~. • a~~ poornc~4 4 Foornc~C a ~
SLJD~hI~y ~LASS WOR /~J2~~1: TYPC oP DaaR:
S~.ip~~lC~ C~L~759 a00R5 Nl•~c OrR~{ 7t3Tf.D FoR"R=v~1~-K~ TNLyASG Ll ~-li*ED
ADO?~ Ad0 M°.y B• ~SSitiN/~.L? A VIS~G~/~IGSAP[3 11AV~iL OF•1~"r ,~c~rD~r,
QtG i~LMS
~-l4 j. V'ha s 1/ Fwri 4~-
DooR ~R~ A~ IYPG oF Doc~R :
D~~~L UNI'YS HAYG 8P-fN TL~TCO AND RouuO To NI~VG AM
'FZ"_V~~us o~ 'T,81 ~+~c.~KO~N4 ~~w a~tiMS,
- ~/R = 1/ 1.$ ./Z~ Fmrw~~-= SS
~ d~ _ ~
5~ec~Ac.s : TypE :
1
,
FaRM s•~ ,~n,.,~R, ~T~'irE•,~~30 ~Ic SrNEa ~
r
~ 0 `
1990 BUILDING PERMIT APPLICATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS M17LTIPLE DWELLINGS COMMERCIAL
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 SPECIFICATIONS
1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGI CALCS
# OF RENTAL UNITS
# OF FOR SALE UNITS
PENALTY APPLIES WHEN: TYPSNG OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL SE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
J UX 2 S RECD
To Be Used For: crc~ Valuation: Date:
Site Address 22,14p W~150g.-~nqTf OFFICE USE ONLY
Lot ~ Block y FEES
Occupancy
/ Zoning
Parcel/Sub G~yL7~,~./ I~ Actual Const Bldg. Permit
Allowable Surcharge
Owner :Iok, # of stories Plan Review
Length SAC, City
Address Depth SAC, MWCC
S.F. Total Water Conn
City/Zip Code Ea A,i'~ S5/c?A Footprint S.F. Water Meter
Acct. Deposit
Phone 4- Sy`E~ F3L5333- On site sewage_ S/w Permit
I On site well S/W Surcharge
Contractor C v Y/ ~ MWCC System _ Treatment Pl.
City water Road Unit
Address -730 9 61l ~ 4v '5• PRV Park Ded.
r Booster Pump _ Copies
City/Zzwo-~Ills- lCy. ~ ~Sl~d3 SUBTOTAL
APPROVALS - Penalty ~
Phone ' 3_5- Planner TOTAL
Council ~
Arch./Engr. Bldg. Off. 717
Variance
Address
City/Zip Code
Phone ik
7422Fttleiprisnbiive
* pI(~NF-Ep Mendata Ilr.iglits, MN 55120
- -
~ eng* e~r ng.. I(6121 ss1-tst4
CertificateofSurveyfor:_ COLLCGc Q/_Y__l~~/uS .
-
-
/ , - - ^
NC7Rt! 1
~II i ' ~tiyP~R~n~G ~TrrA,L 1
~ i?.g9os3,¢L,~ 3 1
psJ%r 6M &0
v~- -
PIlO{Jrz
T ~ /
a
/ N~ . 'I6 ~1• ~
, k~ ~r~
? ~ ~ 1, d \ ' ` \ \ 1 `
~
\ / „ ~
P'O
` / ~~O" . \~•y1 ~ ~ ~ Q ~ ' ' `1a'1 i ~
loL
7 ~
~'p~. ~ ~,h4~ ,t/ Sg/ "'",W,
i
~ -
P.R.G. ~Ep , ..._....._.I~-
. goo.o DPnofPS ex?sfin Elevalrort o~o SEIJ FUSE _~l.EVAITUN
Uertofes proped F/evofra,i /_owest~7oor ~levaliv~t_ y6?,5 •
Un+iolea Drorna ~ Ufrlr~ F_~a,seme?~/ l) o, ~lvck Elevptron 9zo.5 :
Derroles Dra?ne To t1dw 01-raws Garqft SJab Elevatrorl~x~.~.,. _
° Ivtivlvs monument tl Deno)`es 0 f~'sef Nub
Bearin~s sltowtt are ass~.+nrec~ Su l~~ec•% (-o [cr,seme>>hs 01"'fkar•d
L OT_ 18L ackl4, WNt 5pta1NG woods FovaYQaa
vquoT~a coyNry
1 I r~r )Y rrrl fy IhP\ th t Ii 0 I IIP qllll COllnct IP,r1PtC1110\IOp OI A SIIIVPY nl IhP bMundnrins of IhC nhove/~fcenibril land. nnrl nl Ihr la,alinn pofell
hulldin~., thprron, nnd nll vifibla nnr,ronrlimenlit, 11 nnV, frorn or on sqld Inad. M1t Survn.yrd hy mr lhie_7L`{-r1aY of_NQ.(~ /~.fl. 1gpL.
/
ca/e p, ee~
ZI~O 1111AF1il A.cIWIi11.5.1iFr Nfl n1101
~ * * * 2422 Enteiprise Drlve
Ar PIOIVEER Mendota Heights, MN 55120
* eng* eering., l (612) 681-1914
I
Certificate of Survey tor: COL LE-GE CI / / CQN.7 / 7
- - - ~
' -riZA ?L NORTN
~s
l ' ~ ~ . 1 / ~ ~ •
a .V
Q°~ O /0
0
..j ~
\ / ~ 0! ne•`'t ~ ~ ' ~ \
~ .
`0
M
^ '
o - (AP'
~ ~ . • fi e~•`!' ~
lo/ tipo I I .
4z.o - __j
~1~~ 1M~ 54, gs i?.8i• Sg, 17„W . ,
C '
. ~ ~ L
p
poG~aQV. G~~QU9R
E D
. =EN [1~iEERI1~~ DEPT
900.0 Dcnofes ex~sfrn¢ Elevalion ,~o~os N EELEVATIUN
•.900.o Derlofe5 propd~ed E/eva(ir~rt Lowesf Floor ~ eva ran y62,5 •
-dhnofes Uraina e( Ufrli~ Easemenf Topo,''BlockElevativn-9za.s:
Denoles Drainc~ie F1ow Qrraws Garn e S/ab Ilevcrfianq~i.z:
a Deno~es monumenf o Deno`es Otf~'sef Nub .
Bearins shown are assumed Su Jec1l lU EtYSPIr)P_r11s 01"'RPcord
LoT 1_7 BLacu 4, WN! SPtalNG WOODS t 4uQIIl,QDp,
a,~uoT,a coy,vey
I here y cerUfy lhat th is a t ue xnA correct renresentTNon ol e survoy of the Aoundaiias nf the above ecnibed land, nnd of the locatinn ~opf 811
bulldings, therron, nnd xll visihle encronchmenis, il any, from or on saih IanA. At surveyed hy ma ihis7ffi day ol xQ1/ A.D. 192L_,
Sca/e :1 ~nch, ~O, ee~ a-
_r~fL
'Lj6 RnRFR f R. SIKIrH 1.,5. RFG. NO, 4q9} 7
{
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA179324
Date Issued:09/28/2022
Permit Category:ePermit
Site Address: 2246 Whispering Tr
Lot:001 Block: 004 Addition: Whispering Woods 4th
PID:10-83953-04-010
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Includes Skylight
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any
repairs must be inspected prior to covering. The inspector will determine if an additional permit will be required to repair the
water damage.
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 Total:
This permit shall be null and void if work does not start within 180 days of issuance, or if work is suspended for 180 days or more after
started.
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 -
Thomas F Grzechowiak
2246 Whispering Trl
Eagan MN 55122
Pcs Residential
2005 Pin Oak Dr
Eagan MN 55122
(651) 994-2028
Applicant/Permitee: Signature Issued By: Signature