3757 Windtree Dr r _ ,Y - . . - . . . '
" L< DATE: SEP 17, 1990
RE: 3757 WINDTREE DR (MONTGOHIERY DESIGN)
x YoWSewer & Water Permit for the above property has been completed_ It will be held at the
-Pjblic Worics Garage (3501 Coachman Road) until the meter is picked up. BE SURE TO
ACALL PUBLIC WORKS (4545220) FOR YOUR PERMANP-NT WATER TURN ON.
•Your Sewer & Water Permit for the above property cannot be completed for the following
reasons: - -
Your Sewer & Water Permit far the above property has been completed, but the meter cannot
be issued or occupancy allowed until further notice.
COMMERCIAL PROJECTS ONLY: Please pay for meter at C+ty Hall. Meter size must be%
confirmed by Bill Adams or Dirk House (Plumbing Inspectors - 454-8100) before issuance.
WARNING: BEFORE DIGGING, CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC.
- REQUIRED BY LAW.
CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY.
Secretary, Building Inspections Dept. ~
INSPECTION RECURD ~Controi No.
CITY OF EAGAN PERMIT TYPE: P~ ~~-PiMa
I 3830 Pi4ot Knab Road Permit IJumber. 08191111119 '
Eagan, Minnesota 55123 Datg Issued: t2/49/ 9`
~ (812) 881-4575
SITEADDRESS; Lp7 ~ 0046 StpCK, 4086PPLICANT:
3767 wtMuiAkr DR NEAT-M-4L0 FTREPLAC!$ '
.14100SRE~ OTN (61,2) for#-975e -
PERMIT ~~JBTYFE: TYPE OF WORK:
F rR. 1_qc NEw
INSPECTION
I ~t~r~~R ~?~.t
. ~
IrJ
1- I I I1
p r_
.~.'k.p-Y"
PNmt No. PGmlt Nddsr Dtle TN~phon~ ~
~.~lYI!
PLUMBING .
MVAC .
ELECTRIG •
ELECTRiC
In.p.oao~ a.l. Ynp. co„u,wfr
Foatirqa !
Foundmtlon
~
PICX"
iao~gh Rb~ .
I Fough
~ITrw-
Rnal~.
arset Te*
RM PEO• Ptp. Inepeeepr-J;plfly PMwber
Coitit IMeter
ftWJPlen
. R4 Firmd
Decic Rp.
Dedt Firrel
VY911
Pr. OiBp.
• , . . _ _ _ r . . . _
CITY OF EAGAN ~ 8251
" 3830 Pilot Knob Road, P.O. Box 21-199, Eagar~, M14 55121
~ T PHONE:4S4-8100 ~
BUILDIW ERMIT Receipt # ` y,~
To be used tor " Sg ~/GAR Est. Value =i7s+000 Date wW- 10
Site Address 3757 WINDTREE DR
Lot g_Block i Sec/Sub. WIHOTS$E 8'17I OFFICE USE ONLY
PSrC@I N0. Occupancy 21-3 M-i FEES
zoning
!l01iTG0!lSRY DBSIGI~I (Actuaq Const y ~ Bldg. Permit
W Name 90Z.00
~ Address 3786 WRNn?RES DA (Allowable) 14
Surcharge 87•~
City Phone "1-1773 k or Sto~es
~ ~A~ Length ; Plan Review
o Name r~tn sac. ciry 100400
~ V ,
~ Address S.F. Total
U City Phone S.F. Footprints _ SAC, McwcC
On Site Sewage - Water Conn 62s.00
~s
Name or, ste wen
t W Water Meter 90•00
~ ; Address Mwcc system ~ 30~
K W Clhl Phone Cdy Water ~ Deposit •
PRV Required _ S/W Permit 30.00
I hereby acknowle9~ that I havQ read thfs application and state at the Booster Pump - ~yy Surcharge
infprmation is correcT and agree ,to comply with all applicable S te of
Minnesota Statutes an~it~y of Eagan Ordinances. ~ Treatment PI Zs2•~
Signature ot Permitee - •1'~ APPROVALS Road Unit 3ss•~
A Building Permit is issued to: ~Y D~I~ P~'~r - Park Ded.
on the express condltion that all work shall be done in accordance with all Council -
applicable State of Minnesota Statutes and Ciry of Eagan Ordinances. gldg. pff. _ Copies
Variance - 70TAL 3~6~~~
Building Official i -
~ .
perwA No. Permit Holder Oate Tekphone N
WATER ~P3~ I 9/~ gJ
SEWER
PLUMBING 0
H.vAC. 9 dcs gv
ELEcraic . ~ ' /o ro p cv
Mapeetia, wee In,P. comm.nb
Footings I
Foundation
frartwrg
Roofing
Rough Plbg. -2 46
Hts. Io o
Fireplace
i
Final Htg.
Final Plbg. /
Consy. Me(er Plbg. lnspec,YOr - Noti1y Plumber
EngrlPlan
Bld,. Final - ceat b k
Dedc Ftg.
Dedc Final
WeR
Pr. Disp.
; PLUMBING PERMIT For Offiw~lr pnly
CITY OF EAGAN PERMIT # 3~~
CONTRACT 3830 PILOT KNOB ROAD, EAGAN, MN 55122 RECEIPT #
PFJICE PHONE 4548100 DA'TE: Site AdCss 3~~ 1 W•~'a ~~c• R BLDG. TY, fE WORK DESCRIPTION ~
Lot ~ Sec/Sub Res. A_ New ~C
vr L, <5 7-tl Mult. Add-on
A( It T1 b Comm. Repair
~ Name
~ Address (P U C.Itcct L- Other
~ City 3 a~~~ Phone RE3. PLBG. ONLY - COI~APLETE THE FOLLOWING:
- NO. FIXTURES TOTAL
3 wamr ciosec - ~.oo $ _
Name Ad 1 c a, ~ Bath Tubs - S3.00 5
~ Address 3 ~ ' W _ < < v4 r Lavatory - $3.00 9
- - ~ ~~y: Vhower - V-oo
Kitchen Sink - $3.00 ]
UrinaVBidet - $3.00
FEES ~ Laundry Tray - $3.00
COMM./IND. FEE - 1% OF CONTRACT FEE Floor Drains - $1.50 APT. BLDGS. - COMM. RATE APPLIES ~ Water Heater - $1.50 TOWNHOUSE & COMDO - RES. F1ATE APLLIES 1 Whirlpool -;3.00 3
MINIMUM - RESIDENTIAL FEE $12.00 I Gas Piping Oudets - $1.50 MINIMUM - COMM.IND.IFEE $20.00 (AAINIIiAUTA -1 PER PERMIT)
STATE SURCHARGE PER PERMIT .50 Softener _;5,pp
(ADD;.50 S/C PER EACH $1,000 OF P?ERMIT FEE) WeN - $10.00
~ Private Disp. -510.00
Rough Openings - it.50
U. G. Sprinkler System - $12.00
SIGNATURE OF PERMITTEE
PERMIT FEE: 4 )E '
STA7'ES S/C:
: FOR: CITY OF EAGAN GRAND TOTAE: y~-
.
f Vi~ x
~ ~~I: aS.
0#*• ~ a
, •']._-c G~i'-= - MECNANICAL PERMR PERMIT #
• cmr oF E?aAN REcEiP'r #
34190 PILOT KNOB ROAD, EI?GllN, MN 56122 ',='=-,/c~ ~
CONTRACT PRICE PHONE: 04-8100 DATE:
3ite Addcssa , - BLDG. TYPE WORK DEDCRPTION
Lot • Block/Sub p~ N~
77
S
Mult Add-on
m Name Comm. Repair
~ Address
c City PhOne oew
FEES
N8111e r , t ~ ` ` i - , • ; i .1,.1 RES. HVAC 0-100 M BTU - $24.00
c Address ~ : v • V ~ ; ~ - ADDITIONAL 50 M BTU - 6,00
p Ciry Phone - (RES. HVAC INCLUDES MC ON NEW
COMSTFiUCTION)
GAS Olt7LETS (MIMMUM -1 PER PERMrI): ~ 1,00 F-?•
T1fPE OF WORK COMMAND FEE -1X OF CONTRACT FF.t "Forced Air M BTU APT. BLOCiS. - COMM. RATE APPLIES
Boiler M BTU TOWNHOUSE & CONDOS - RES. RATrz APPLIES
~ Unit Heater f M BTU k*MuM RESIDENTIILL FEE- ~ 8 - 12 ~
Air Cond. M BYU MINMAUM COMMERCWL FEE - 20.00
Vent CFM STATE SURCHARGE PER PERM(T - .50
Oas Piping Oudets # ~ (ADD $.50 SIC PER EACH $1000•00 OF PERMR FEE)
Other
PtRMIT FEE: . , _
31dNATiJRE OF PERMITTEE SIC: - i
TOTAL: ' FOR: CITY OF EAQAN
t
SEWER & WATER PERMIT OFFICE USE ONLY
CITY OF EAGAN M~TER jv ~13 7(p 74 PERMIT DATE 09 / 17 / 9Q
3830 Pilot Knob Rd. 11645
Eagan, MN 55122-1897 CHIP '36 ` PERMIT #
METER SIZE Racle, B.P. RECEIPT # C19454
DATE j AUGGST 10, 1990 ISSUE DATE B.P. RECEIPT DATE 08 14 90
- PflV _ BOOSTER PUMP
SITE ADDRESS 3757 WINDT[2F.E LR PERMIT REQUESTED
LOT 5-BLDCK L SEC/SUB WINDTREE 8T13
X SEWER X WATER TAPS
Montgamery Design & Build -
APPLICANT:
ADDRESS: 37$6 Windtree Drivs ' -COMM/IND _X_ RESIDENTIAL
CITY, STATE Eaytan, MN Zip 53123 X NEW _ EXISTING I
PHONE: 681-9230
Valley Plumbing Lawn Sprinkler Meters are to be Installed I
PLUMBER: Ahead of Domestic Meters on Water Line. i blUr ADDRESS: ree ane redit L NOT be iven for Deduct eters. j
CITY, STATE Jardan, AiN ZiP '55352 I
PHONE: ~*42-2121 ~
I AGREE TO COMPLY WITH CITY OF
OWNER: t~fONTGOr:ERY DESIGN EAGAN ORDINANCES I
ADDRESS: 3756 WII3DTREE DR ~
CITY, STATE EAGAN, MN ZIP 55123
PHONE: 681-177 SIGNATURE WHEN ME R ISSUED
, 1 i r , ,
PLEASE ILOIl~'~11V0 OR N(i D ~ O~PROCESS~ING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
SEWER PERMlTS, CONTACT ENGINEERING DEPT.
SEW€R $ V(ATER PERMIT OFFICE USE ONLY
CITYaF EAGAN METER # PERMIT DATE 09117/90
3830 Pilot Knob Rd. 11645
Eagan, MN 5P122-1897 CHIP ~ PERMiT ~
METER SIZE B.P. RECEIPT # C 9454
~.DATE Alret'ST iC, 1949 ISSUE DATE B.P. RECEIPT DATE 08/14/'9U
I
_ PRV _ BOOSTER PUMP
SITE ADDRESS 3757 1`:0TVEL'' `i;R PERMIT REQUESTED
LOT r) BLOCK t SEC/SUB WINDTREL 8TH
h SEWER x WATER _ TAPS
APPLICANT: rioatgomery Ueiign & nnild
ADDRESS: 3786 Windtree Drive - COMM/IND RESIDENTIAL
CITY, STATE Eagan. MN Zip 55123 Ji NEW _ EXISTING
PHONE: 681-9230
Valleq Ylumbing Lawn Sprinkler Meters are to be Installed
PLUMBER: Ahead of Domestic Meters on Water Line.
ADDRESS: 6lu reb ati! redit L NOT be iven for Deduct eters.
CITY, ST Jordan, 21 ZIP 55352 !
PHONE:
I AGREE TO COMPLY WITH CITY OF
OWNER: MONTGOMERY ,iESIGN EAGAN ORDINANCES
ADDRESS: 3186 WIt!DTf:r;E UR
CITY, STATE y~GAN • EN ZIP 55123
PHONE: '81-177"i SIGNATURE WHEN METER ISSUED
I
PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT.
~ CASH RECEIPT
~
CITY OF EAGAN' 3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55722
DATE 79 JSL
aeclIENEo j
FROIA
~
AMOUNT $
& DOLLARS
,oo
? CASH YCHECK
Z ) ~ , S /
FUND OBJECT AMOUNT
Thank You -
eY
C 9454 White-Payers Copy
Y~bng Copy
Pnk-File Copy
/oi0 50
9 07/0
a 19 84 ~ / ~~ooo
ReQUestData Fire No. Roup~-m Inspectron ?
/D 67 ~ Requretl4 ReaEy Na Will NoUty Inspecior
~es ? No When Reatly?
I icensed contractor ? owner hereby request inspection of above electrical work at:
JoD AEtlre55 (SVaeL Box or Roule o) )Pty
~ W~I//"PW~
SBCtiOn N0. TOwnSlnp N2mB or N0. RangB NO COUn ~
Oc[u0anttPRINT) Phone No
~ ~Q--
Power plier Atltlms '
Eleclr I Convactor(COmpany Name) . ConVact r Lroense No
Pi' S =3
ai/fW~,,ass (COmractor or Owner Makmg Inslallatron)
l..C/ ~
Author e SignaWre (Comraao,lOwn aking Inslallatmn) Phone Number
g9D 'lo
MINNESOTA STATE BO/RD OF ELECTRICITY THIS INSPECTION FEOUEST WILL NOT
Grlp9s-Mldwey BICp. - Room S113 9E ACCEPTED BV THE STATE BOARD
1811 Univerelty Ava., 51. Vaul. MN 5510C UNLE55 PROPEP INSPECTION FEE IS
Plwne (617) 642-0800 ENCLOSED
It)/O U REQUEST FOR ELECTRICAL INSPECTION
//I .~:ea insimctions tor <ompleting ihis torm on back oi yellow copy
~I 1.9 g.~~ "X" Be/ow Work Covered by This Request
e Adtl Rep. TypeofBwlding AppliancesWVetl EqwpmentWired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Builtling Dryer Other (Specity)
Comm./Industrial Furnace
Farm Air Condihoner
Other(spi Contrxtor4 Remarks'
Compufe Inspection Fee Below:
B Other Fee # ServiceEn[ranceSize Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps q Z
Transformers Above 200 _ Amps AOOVe 700 Amps
SigOS levspecmr5 Use Only: Av OTAL
Irngation BoomS Q~ ~
Speaal Inspecti0n
AlarmlCommunication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, ihe Electrical Inspector, hereby ROuBh-m ( o'i
Certify that the above inspeCtion has p,nai ~ O~
been made. X/
OFFICE USE ONLV
Thrs repuast wq 18 months Imm
CITY OF EAGAN NO 1825 1
~ 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
BUILDING PERMIT PHONE: 454-8100 ~ /~~[7 {
Receipt #
i
Tobe, usedfor SF DWG/GAR Est value $175,000 pa1e AUG 10 , 1990
Site Address 3757 WINDTREE DR
Lot 5 Block 1 Sec/Sub. WINDTREE 8TH OFFICE USE ONLV
Parcel No. acuPancy R-3 P-1 FEFS
Zomng R-1
w Name MONTGOMERY DESIGN (Acmap Const V=N Bltlg. Permit 902.00
o Address 3786 WINDTREE DR (nnowable) V-N somnarqe 87.50
City EAGAN phone 681-1773 nolStories _
lengih 701 PlanRewew 5$6.00
;io Name SAME oepcn 3' sac,Gry 100.00
pU
Address S.F. Total
, F - snc. nncwcc 600.00
City Phone s F Fooiprinis _
F On Site Sewage _ Water Conn 625 f10
$w Name On Site Weil - Water Meter 90.00
Address Mwccsysiem X]L
aw City Phone cnywater 7(]{ Acct Deposrt 30.00
PRV Reqwred - S!W Parmit 30_ no
I hereby acknowle ihat I hav reatl [his a Lcation and state at the Booster Pump - SMI Surcharge • 50
inbrmation is correc agr e to comply ih all applicable te of
Minnesota Statutes an Crt ot nan s. Trealment PI -----G0
Signature of Permitea APPROVALS Road Unil 35$.00
A Bwiding Permrt is issued toMONTGOMERY DESIGN Pianner - park Ded.
on the express condition that all work shall be done m accordance with all Council
apphcable State of Min,nr~esota Statutes and City of Eagan Ordinances Bldg Oif Copies
fl
8udding Oflicial I I/~ l ,n P.O"A 1 . j Variance - TOTAL 3,658.0
Address: 3757 WINDTREE DRIVE Lot 5 Blk I Sec/Sub WINDTREE 8TH
These' items were/were not complete at the time of the final inspection.
'DATE: NOVEMBER IS 1990 Yes No INSPECTOR:
Final grade (6" from siding)
Permanent steps - garage ?
Permanent steps - main entry
Permanent driveway
Permanent gas ~
Sod/seeded grass ~
Trail/curb damage
Porch ~ ' j ~ - hof rockt
Basement finish
Deck
Please verify with the builder the removal of roof test caps from the plwobing
system and the shut-of£ of water supply to the outside lawn faucet before
freeze potential exists.
0
White - City copy Yellow - Resident copy Pink - Contractor copy
v'
r ti
(~rr#ifir~t~ nf (~rru~~nr~
.
Citp of Cagan
igP}ImtIlIPt11 Af %atltg ip8}iPttIDtt
This Certifrtate rurred pursuanl ta J/te requiremenCS ojSer»ors 306 ojlhe Utijorm Building
~ Code tertijying that al !he time of issuance llus sYiucture Kas in compliance wilh !he variorcr
ordinanoes ojlhe City regulafing building mnstruction or use Farlhe foUowing:
thep,mfiv6m CF []~`/!`AR WAq,P..ft W IR951
anV„-Y Tyy. R'i/MI zodit wa~ RI ryacmt VN
Owurrot&ddm4 MP]ITYT/RRP 17RCTRJ AddQy 17Afi GTINITfRRR T1R. ~ RM.AN
e„M,e Ad*m 3757 LdINITtRi~ IFiNF. ~y;ry i5. B 1. WIIdITLRNE S'lA
/,L(/ uic D~ 1S 1M
~
PoST IN A CQNSPoCUOUS PUCE
~ 2005 RESIDENTIAL BUILDING PERMIT APPLICATION ~ U
City OfEagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone 9 651-675-5675 FAX 4 651-675-5694
New Construction ReauiremenGS RemodeVReoair ReouiremenGS Office Use Onlv
3 registered site surveys showirg sq. h. of lot, sq. ft. of house; anA all roo(ed areas 2 copies of plan Ced of Survey Recd _ Y_ N
(20% mazimum (ol coverage ahowed) t set of Energy Cakulatwns for heated additions Tree Pres Plan Recd _ Y_ N,
2 copies of plan showinq beam & window srzes; poured found design, etc. i sile survey for addttions 8 decks Tree Pres Requi2d Y_ N
1 set of Energy Calculations Adddion - indicate Aon-sde septre sysfem On-site Septic System _Y _ N
3 copies of Tree Preservation Plan if lot plaHed aher 711193
Rim Joist Detail Ophons selection sheet (buildings with 3 or less unAS)
Date Construction Cost
SiteAddress 3 7.S 7 //n df/'2Q UniUSte #
~6R N iv SS ~z 3
Description of Work ru o F
Multi-Family Bldg _ Y~. N Fireplace(s) 0_ 1 _ 2
Property Owner JIqV 1j 6.oQnc1 LJ~ u l,S " Telephane #(~S' - LZ./ ~
Contractor el 0 4.Ijl2r
Address ' City
Slate Zip Telephone # ( )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy CodO Category . Residential Venlilation Category 1 Worksheet ^ . New Energy Code Worksheet
(Jsubmissiontype) Submitted Submitted
• Energy Envelope Calculations Submilted
In the last 12 monihs, 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 ielephone # ( )
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 start without a
permit; that the work will be in accordance with the approve an in the case of work which requires a review and
approval ofplans.
Applicant's Printed Name ApplicanYs Signatuze
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garege ? 22 PorchfAddn (4-sea.) ? 33 Ext. Alt - SF
O 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 LowerLevel ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
Work Types
O 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Buitding ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building• ? 43 Reroof ? 46 Windows/Doors
? 34 ReplaCement 'Demolition (Entlre Bldg) - Give PCA handout to applicant
Valuation Occupancy MCES System
Plan Review 100% or 25%
Census Code Zoning City Water
SAC Units Stories Baoster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width _
REQUIRED INSPECTIONS
_ Footings (new bldg) _ Final/C.O.
_ Footings (deck) _ Final/No C.O.
_ Footings (addition) _ Plumbing
Foundation HV AC
Drein Tile Other
~ Roof _ Ice & Water _ Fina] _ Pool _ Ftgs ^ AidGas Tests Final
_ Framing _ Siding _ Stucco _ Stone _ Brick
~ Fireplace _ R.I. _ Air Test _ Final _ W indows
Insula[ion _ Retaining Wall
Approved By: , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utiliry Connection Charge
S&W Permit & Surcharge
Treatment Ptant
License Search
Copies
Other
Total
.
.
1990 BUILDING PERMIT APPLICATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS MULTIPLE DWELLINGS COMMERCIAL
2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUGTURAL PLANS
1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS
# OF RENTAL UNITS
# OF FOR SALE UNITS
PErALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DA1
OF MONTH IN WHICH REQUEST IS MADE.
LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER LOTS - CONTRr1CTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES IdILL BE ALLOWED ONCE BUILDING PERAfIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERhiIT HAS BEEN COMPLETED.
PERPiIT t•SUST SHOid A LICENSED PLUPIBER.
A U 6 07 RECO
~ q'~L
To Be Used For: ~L. Valuation'"'~ Date: (Q~
Site Address OFFICE USE ONLY
I ~5, ooo-
Lot J Block ~ FEES
Occupancy -3 M-/
r' ~{.Zoning R _I
Parcel/Sub`W1Ny,~ Actual Const \/-N Bldg. Permit 9d2.00
/ Allowable V-/J Surcharge 50
O,:,r.er~Tp~~~ of stories Plan Review 5$(„0
O
2~- Length f]O' SAG, City f00,00
Address Depth SAC, MWCC 6,00. Dv
S.F. Total Water Conn '1~(0 5,00
City/Zip Codelis~ Footprint S.F. Water Meter D.LYJ
1 Acct. Deposit ~p.00
Phone (QN ' 1.~1F2 On site sewage_ S/W Permit 30-D0
On site well S/[2 Surcharge .5D
Contractor~~ MWCC System -7 Treatment P1. Z.r-~Z.DO
City water ? Road Unit .O
Address PRV Park Ded.
Booster Pump _ Copies
City/2ip Code SUBTOTAL
APPROVALS Penalty
r
Phone Planner TOTAL 3.."-
-7 ' ` Council
Arch./Engr.~~j-.lt~-. Bldg. Off. 5&6
Variance
Address
City/2ip Code
~ne n e)CU~ -50(iq
U A2A~~
3~ x 2~ =~yo xiS= I ZG oa
C~sYNT ~ PE5r -TLcO+2
3Z Xyo = 1 Z00 83~6
Ptinu -
Zt-{. ~C y D= c G 6 n
zti,_r~>
3y x 40 = 13~0 X 51= ~~360
~'ly ?2 d
~ ~ . . o,* I
902•00+
b7•50+
586•001-
2 ,Of32 • 50+
3)65E1•00*+
~
902•00+
~ 87•50+
586•00+
2)082•50+
3,658•00*+
- - MONTOD RY UkSI N
~ %'OIVEYOR'S CEATlFICATE ~ I
xei6, i
Wl'NpT
II°35'37~~ ' a ' o DR, ~+I
I o
3• 29 ~ R~ s ~
L a~ M ue. i'`
x Me
'r1G.3
o 0 1
A~ o N;
4 W y ~
0 0
wWf
~ • 012.1 9~7 rp O~
w „a
~40.0 N T~ 7yy~ m/ A ,f.
0 o RoPOSEp N 30.0 M ti ~ F1OUSE / I
9oa, ' v / /GARAGc ~o p T x / I
40.p o N i O
• ~ xaio.B oi 30.0 ~ on IZ, • !
i ~~/Z • ~ ~ 1 TM xNl.b
! L 3
= o
~ o w ;
w
i k •
i M
~
0
i ~ I N
Q ~ ~D nQ r ~
LOT 5 u ~
r~ 1 I
oaaNAcE e uritmr h ,
~ICH7' P$!V PLAI'
lo
109,00 10 ,
~ N 70,301094 OENOTES PROPOSED SURFACE DRAINAGE
O DENOTES IRON MONUMENT SET SCALE: 1 INCH - 80 MT
• DENOTES IRpN MONUMENT FOUND PROPOSED GARAGE FLOOR - qEET
X000.0 pENOTES EXISTING ELEVATION PROPOSEP LOWEST FLOOH -1aT•'y EET PROPO (OOO~ OPENOTES ENO ES AILSg~TLEVATION PROPOSEP TOP OF 9lOCK- Z1~.j ~ET
WE HEREBY CERTIFY 70 MONTGQMERT DE SIGN THAT THIS IS A TRUE AND CORRECT REPftESENTATION OF A SURVEY OF THE BOUNQARIES OF: I '
r.OT 5, gLOCx I, WINDTREE 8Tx ADDITION, ACCORDING
TO THE RECORPED PLAT THEREOF, DAKOYA COUNTY, MINNESOTA
IT DOES NOT PURPOAT TO SHOW IMPROVEMENTS OR ENCROACNMEt~jS, .QEPI`AS~S~`iQWIJ.`~
SURVEYED BY ME OR UNDER NIY DIRECT SUPERVISIdN THIS
, SIGNED: J ES R. HILL, IPJC~
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BY: JOHN C. LARSONq,LANp SURV.Ef49F1xF,=tP'q''2 4
MINNESOTA LICEIVSE NUM9ER 19828
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3706 WIIVDTRGE pR
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681-9230 ;RNDQU:CST
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8 DUOR AREA qG 10 5
G SI_IUIIVt:, C;LRSS A,2G!'; 60 oti 39
p FIRLPLACG AREA 0 0
E' WALL FRAME AREA 286.4 095 27
F NE'f UJALL AREA 2217.62 ,035 84
, Gn R.IM JIJIST AREA 07 .0136 7
H_ . FOUND WINDOW AREA 0 0
Ffl)Np ABOVG URpGl3 85 .06:3 6
T07AL WAI_L AREA 254 .
SKYI_LTE p 5 p"
, K! ROOF FRAME 136 .032 4
L,: . NET ROOF AREA 1224 .022; 28
:4:: - ' TOI'AI_ ROOP AREA 31 , t
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O DENOTES IFiON MONUMENT SET SCALE: i INCH - 30 EET
• DENOTES IRON MONUMENT FbUND PRpPOSED GARAGE FLOOR - EEf
X000.0 DENOTES EXI571NG ELEVATION PROPOSEp LQWEST FLOOR - EET
(000.0) DENOTES PROPOSED ELEVATION PROP05ED TOP OF BLOCK - EET
'n, DENOTES NAIL SET .
WE HEREBY CERTIFY Tp MONTGOMERY DESIGN THAT THIS 1S A TRUE AND CORRECT
REPRESENTATION OF A SURVEY OF THE 80UNDARIES OF:
ILOT 5,-BLOCK 1 , W IN D TREE 83'H ADDITION, ACCORDING
[TO THE RECORDED PLAT THEREOF, QAKOTA-` COUNTY, MINN£SOTA
IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCRbACHMENTS. EXCEPT AS SHOWN. A;
SURVEYED BY ME QR UNDER MY DIRECT SUPERVISION TIiIS 6TH pAY OF AUGUST . 1990.
SIGNEO: J ES R. HILL, INC.
BY:
JOHN C. LARSON, LAND SURVEYOR
MINNESOTA LICENSE NUMBER 19828
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= o co . James R. H I ll I I"1C.
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- 9401 JAME5 AVE. S. ~ BLUOMINGTON, MN. 55431 • 6112- -3029
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C ITY OF EAGAN PERMIT C°n 1374
3830 Pilot Knob Road PERMIT TYPE: a u z Lo z iv G
Eagan, Minnesota 55123 Permit Number: 0 0]. 9 A 8
(612) 681-4675 Date Issued: 1 Z(@ g/9 z
SITE ADDRESS:
3757 WTNDI"REE DR
LOT: 0005 BLOCK: 0001
WTNDTREE STH
P.I.N.: 10-84A77-050-01
DESCRIPTION:
'Build-'ing Permit Type FIREPLACE
Bu5ldiny",W\ k Type NEW
\
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REMARKS: C~a t a-7 S
FEE SUMMARY:
Base Fee $25.00
Surcharge $.50
Total Fee $25.50
CONTRACTOR: - Applicant - sT. LlcOWNER:
HEflT-N-GLO FYREPLACES 18900758 0002960 5ANQUIST DAVE
3850 W HWV 13 3757 WINDTRtI_ DR
BURNSVTLLE MN 55337 EAGAN MN 55123
(612) 890-0758 (612)454-2218
I here6y acknowledqe that T have read thi.s applicat'ion and staCe that the
information is correct and agrec L'o comply with all applicable State oY Mn.
~ Statutes and City o1' Eagan Ordinances. J
~f T APPLICANT/PERMITEE SIGNATURE ISSUED BY: SIGNATU~R
ff
INSPECTION RECORD Control No. 1374
CITY OF EAGAN PERMIT TYPE: B U I L D I N G
3830 Pilot Knob Road Permit Number: 001908
Eagan, Minnesota 55123 Date Issued: 12 / 0 9/ 9 2
(612) 681-4675
SITEADDRESS: Lor: 0ee5 eLacK: eeeAPPLICANT:
3757 WiNDTREE DR HEAT-N-GLO FIREPLACES
WINDTREE 8TH (612) 890-0758
PERMIT SUBTYPE: TYPE OF WORK:
FIREPLACE NEW
INSPECTION „ . D.
FIRI:F'LFlCE
~ ~
PERMIT # CITY OF EAGAN $L~~T
FEnc774ATE _ 1992 BUILDING PERMIT APPLICATION
• ~ 681-4675
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies when typing of permit is requested, but not picked up by last working day
of month in which re uest is made or lot chan e is re uested once ermit is issued.
Date Valuation of work
[Terant e Address:_ .3757 ~IIN~ T/~'EL C~~~ C~ C;~-/~/~
STREET SUfTE M
Name: (commercial only)
~ BIACK SUBD. k
u~ h
Descri tion of work: '
The applicant is: ? Owner Contr ctor Othe (Describe)
Name ~/a Al QU! S T 16 4 ?r Phone
Property «5T FIRST q
Owner Address 3 ~ 6)~ti~U 1~~lYL-
STREET STE N
City j State Zip
~
Company ' q~X' -'.Z(je a.oPhone d -7~ ~
C011tf8Ct01' Address C. /J License # Exp.
City 5tate /1,/ Zip SJ 3 3 7
ArchitecU Company Phone
Engineer Name Registration #
Address
C1ty State Zip
Sewer 8 water licensed plumber Processing time for
sewer 8 water permits is two days once area has been approved.
I hereby acknowledge that I have read this application and state that the information is
correct and agree ta comply with all applicable State of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant:
_ OFFICE USE ONLY
BUtLDING PERMIT TYPE
? 01 Foundation O 06 Duplex ? 11 Apt./Lodging ~11 16 Basement Finish
? 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. ? 17 5wim Pool
? 03 SF Addition O 08 8-Plex ? 13 Garage/Accessory ? 18 Comm./Ind.
? 04 SF Porch ? 09 12-Plex )Z.-14 Fireplace ? 19 Comm./Ind. Misc.
? 05 SF Misc. ? 10 Multi. Add'1. ? 15 Deck ? 20 Public Facility
? 21 Miscellaneous
WORK TYPE
? 31 New ? 33 Alterations ? 35 Tenant Finish ? 37 Demolish
? 32 Addition ? 34 Repair ? 36 Move
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MWCC System
(Allowable) ]st F1. sq. ft. City Water
UBC Occupancy 2nd F1. sq. ft. PRV Required
Zoning Sq. Ft. total Booster PumP
N af Stories Footprint Sq. ft. Fire Sprinkler
Length On-site well Census Code
Depth On-site sewage SAC Code
APPROVALS
Planning Building Assessments
Engineering Variance
REQUIRED INSPECTIONS
? Site ? Footing ? Framing ? Insulation
? Nallboard ? Final ? Draintile ? Fireplace
Permit Fee vei~c~a,: $
Surcharge
Plan Review
License
MWCC SAC
City SAC
Nater Conn.
Water Meter ~
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
CoPies
Other
Total:
SAC %
SAC Units
2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651-681•4875
New CanshucHan ReaulremeMs lNqq' Remodel/Reoalr Reaulremenh ~
n 3 reylateretl flfe wneya showlny aq. fl. of bt, aq. lf. of house 2 copiea of plan
antl gll roofetl areas (20X maxlmum lot coveraae albwe~ 1 sel o( enerpy calculaNOns for heated addlHoni
> Y copiea of plans (ahow beam d wtrWOw slzea; poured Ind. tlealpn; efc.) t alte wney 1or exfedor atldlMOne R decks
> t se10l eneryy calculaflons
a J coples of hee preservatlon plan If lol platletl aRer 7/1/93
DATE: 4ezi l Z6. Z Da ° CONSTRUCTION COST:
DESCRIPTION OF WORK: Garq e.. G /,flnl
STREETADDRESS: 375~7 D-1v2.
LOT: -6' BLOCK: ~ SUBD./P.I.D. q:16/kb-1¢e 8~ ~1~/17iow _/o • SY~/77 Cl5'O
7-31 wo~k
Name: p/C! Phone n:
PROPERiY Last flnl
OWNER Skeet Address: 3/S / 44VY~Q
city EAG,4N stare: /Y1l~ ZiP: s5123
Company: //a/oeO w/7e^ Phone M:
(area code)
CONiRACTOR
Sheet Addreu: llcense A Exp.
CNy State: ZIp:
ARCHITECT/
ENGINEER Company: I)XOG.ln¢.~+ Name:
Telephone i: ( )
Sheef Address: RegishaNon k:
Cly State: Zlp:
Sewer/water licensed plumber (if installina sewerlwater): Phone (
I hereby acknowledye that I have read this applicaHon, slale ttwt Ihe Infortna cortect, and ree to comply wHh a0 appAcable Stafe
of Minnesota Slatutes and CNy of Eaflan Ordinances.
Signature of ApplicanY.
2. ~
OFFICE USE ONLY ~
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes ~ No _ Not Required
OFfICE USE ONLY
BUILDING PERMIT SUBTYPES
7 01 Foundation ? 07 05-plex ? 13 16-plex ? 27 Porch (3-sea.) p 31 Ext. Alt - MuRi
7 02 SF Dwelling O 08 06-plex ~ 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Aft - SF
7 03 01 of _ plex ? 09 07-plex ? 18 Deck ? 23 Porch (screened) ? 36 Muki
7 04 02-plex ? 10 08-plex ? 19 Lower Level ? 24 Storm Damage
7 05 03-plex ? 11 10-plex PIDg _Yor_N ? 25 Miscellaneous
] 06 04-plex ? 12 12-plex ? 20 Pool ? 30 Accessory Bldg.
JVORK TYPE
S( 31 New ? 36 Move Bldg. ? 43 Reroof
? 32 Addition ? 37 Demolish (Bldg)' ? 44 Siding
? 33 Alteration ? 38 Demolish (Interior) ? 45 Fire Repair
? 34 Repair Q 42 Demolish (Foundation) ? 46 Windows/Doors
• Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
SAC Code 01 # of Stories ~ sq. ft.
No. of Units 0 Length ~ U sq. ft.
No. of Buildings / Width i~ Footprint' sq. ft.
Const. (Actual) 2;64 Basement sq. ft. Census Code 43 8
(Allowable) -,rAl, Main level sq. ft. MC/ES System
UBC Occupancy - Hr, $ sq. ft. 36n City Water
Zoning sq. ft. Booster Pump
PRV
Fire Sprinklered
MISCELLANEOUS INSPECTIONS
? Stucco/Stone
APPROVALS
Planning Building IG Engineering Variance
Permit Fee ~ a5 .-d- Valuation: $ 6 ,0co
Surcharge C)
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S!W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total: ~ a$•
SAC Units
% SAC
Cities Di i~ tal Quality Control
The following image represents the best
available image from the original page.
Every effort was made to capture the content
from the original page.
..._,_iv:J Hricb n HiLL ttvk- ItL PIU:612 2G4-5518 9401 POl
MONTGOfalERY DESIfiN
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, i N 70301 p911 DENOTES PROPOSED SURFACE DRAINAGE
. d DENOTES IRON MONUMENT SET SCALE: 1 INCH - 30 EEf1
0 DENOTES IRON MONUMENT FbUND PROPO$ED GARAGE FLOOR - EET
, K000.0 DENOTES EXIS7ING ELEVATION
, PROPOSED LOWEST FLOOR - ~ EE(
(000.0) DENQTES PF',OPOSED ELEVATION PROPOSED TOP OP BIOCK - EEf "
, A DEPIOTES NAIL 3ET
/E HEREBY CERTIFY TO MONTGOMERY DESIGN THAT THIS IS A TRUE AND CORRECT
EPRESENTA71pN OF A SURVEY OF THE 80UNDARIES QF: .
LOT 5, BLOCK I t W I N D TREE 8TH ADDITION, ACCORDING
' +0 Tfiu i2'::Ct7:ZDCL PLA'i adEREUF, 'tiAKUl'A :,:O:iNT`l, MI.;"J=SQTA '
" DOES NOT PURPORT TO SHOW IMPROVEMENTS QR ENCROACHMENTS, EXCEPT AS SHOWN. A;
' URVEYED BY ME pR UNDER MY DIRECT SUPERVI510N THIS 67H, pAY OF qUGUST , 1990.
SIGNED: J ES R. HILL, INC.
BY: C
JOHN C. LARSON, LAND SURVEYOR
MiNNESOTA LICENSE NUMBER 19828
,
H tles R. H1 ll/ ince
' j m.5 ~ N ~ ~ 0 IF
o z i D "O ~ JNERS / ENGINEERS / S
URVEI )RS
~ ~ ~ m v o MES AVE. S. . BLUOMINGTON, MN 55437 • 612• -3029
~
•
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I
Use BLUE or BLAGK Ink
�-----------------�
� For Office l�e I
�6 Ut IJ� I Pem►it#: � ���/(�YJ I
� � � Permit Fee: � I
3830 Pilot Knob Road i �
Eagan MN 55122 I i
Phone:(651)675-5675 j �e R��: I
Fax:(651)675-6694- � Staff: j
2015 MECHANICAL PERMIT APPLICATION
❑ Please swbmit two(2)sets of plans with all commercial applications.
f , � .� � � i,,{ �J ��,
Date• � � ��! � SiteAddress• _ v `,��ll-� '�_
Tenant: Suite#:
Name: �V C� �C,PnJ�l�t�F'� �CS 1 Pho�: �J7�� �,��-'� ��C�
Resident/Qwner
add���c�►rz�p:
Name EAGLE MECHANICAL LTD. --�'�`�#:
Cantractar A�"�' 10625 Vessey Rd. __city:
Bloomington Mn 55437
S��� Jon Eagle 952-451-0499 - ` r,. ,,
Contac,.- ---- �t`�UL�'r���"C� ¢�' J�t7��� -� D
New Repiacement Addition�d ,�Alteration Demofition
Type of Work Description of work:
NOTE:R�f�nourttec!ami graund mc�ni�d mechanical�pe�ent�s reqaired�!�s��eeritetf b�r Gity
' Cc�de. Please contaat t1�INechanical b�p�ectar fcN inF�ormat�n on{�e�Ftnit�Ct sct�g mei#�Ods.
RESIDENTIA! COMMERC/AL
Fumace New Construction _Interior improvement
Air Conditioner Install P' in� Processed
Permit Type — —
�P .3 —
_Air F�cchanger G� Exterior HVAC Unit
Heat Pump Under/A�v�a ground Tank (_Install/ Remove)
r� Other ��S '�pu� �/��n'(` — —
J
RESIDENTIAL�EES
�60.00 Minimum Add or alteration to an existing unit(includes$5.00 State Surcharge) ���p
�100.00 Residential New(indudes$5.00 State Surcharge) _$ TOTAL FEE
COMMERCIAL FEES Cor�act Vai�$ x.01
$55.00 Permit Fee Minimum
$70.�Underground tank ir�tallatioMremovai =$ Permit Fee
"ff contract value is LESS tt�an$10,010,Surcharz,�e=$5.Od =� Surcharge"
'"If contract value is GREATER than$10,010, Surcharge=Contr�act Value x$O�Q005
*""If the project valuation is over$1 million,please calt for Surcharge =� TOTAI FEE
I hereby acknowledge tt►at this ir�Formation is cx�mplete and accurate;that the worlc wilt be in conformarxe with the ordinanoes 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 pertnit;that the waork will be in acxordance
with the approved plan in the case of work which requires a review and approval of plans. ` /"`
/r ��� j
X �.)�i'✓`1 l.- �C'l �� X v
Applicant's Printed Name Applica ' :�ignature
FOR OFF�E USE
Required Ir�spections: Revee�w�d By' �e-
Urrcierground Rcwgh In 1�ir 1`e,st : Gas Service Test In-flewr Hest Fir�l' Ifi/AC Stresning
For Office Use
;�* Permit#:
E AGAN
Permit Fee:
Date Received:
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff:
buildinginsoections(a�citvofeacian.com L
2018 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date:'3 v2+.)° l 8 Site Address: ( ✓'fit'
Tenant: \-� V' e"1/ v‘ � its ✓l7+ Suite#:
Name: ���/t.w —J / 6(8 r" 1^-4 f ev Phone: 'S j"" 2d 6v 7 70
ResidenuOwner /
Address/City/Zip: 7S 7 4.4) /�/1/ S S It'd
Name: License#:
Contractor Address: City:
' State: Zip: Phone:
• Contact: Email:
Type of Work —New )(Replacement Repair Rebuild —Modify Space —Work in R.O.W.
1 ._ yp
Description of work:
RESIDENTIAL
Water Heater
Water Softener
Lawn Irrigation (—RPZ/_PVB)
Permit Type Add Plumbing Fixtures(—Main/ Lower Level)
Septic System
New Water Turnaround
Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener(includes State Surcharge)
$60.00 Lawn Irrigation (includes State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment,Water Turnaround*(includes State Surcharge)
*Water Turnaround (add$280.00 if a 3/4"meter is required)
$115.00 Septic System New(includes County fee and State Surcharge) TOTAL FEES $
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
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.citvofeagan.com/subscribe.
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 hout a permit; that the work will be in
accordance wig the approved plan in the case of work which requires a review and approval of• s. /
„` ►� 0110
wir - ..
• ants Printed Name App nt's igna r
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Rough-In Air Test Gas Test Final
Meter Related Items: Meter Size Radio Read Manometer Staff:
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA178794
Date Issued:09/02/2022
Permit Category:ePermit
Site Address: 3757 Windtree Dr
Lot:005 Block: 001 Addition: Windtree 8th
PID:10-84477-01-050
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 -
Steven J Borntrager
3757 Windtree Dr
Eagan MN 55123
(651) 206-8770
Walker Roofing Company
2270 Capp Rd
St Paul MN 55114
(651) 251-0910
Applicant/Permitee: Signature Issued By: Signature