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1708 Woodgate Lane CITY OF EAGAN Remarks ,4ddition Woodgate 3rd Addition Lot 25 Blk 1 Parcel ,10 84602 250 Ol Owner= Street 1708 Woodgate Ln. State Eagan, MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. 1977 476.67 158.89 3 476.67 C003259 0-9-76 STREET RESTOR. RADING 1974 $37.67 $7.53 5 PAID a SANSEW TRUNK 1974 $65.31 $4.35 15 PAID * SEWER LATERAL 1976 3 WATERMAIN ' i* WATERLATERAL 1976 3 WATER AREA 1976 3 * STORMSEW TRK 1976 $1628.80 $542.93 3 PAID *3`qST0RM SEW LAT 1976 3 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. $160.00 1763 12-5-75 BUILDING PER. #3808 1 sac 425.00 1763 12-5-75 PAR K CITY OF EAGAN Remarks Addition Woodgate 3rd Addition Lot 26 sik 1 Parcel 260 Ol Owner Street 1710 Woodgate Lxl. State Eagan, MN 55122 ~ ~ ~~~rQn Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. 1977 476.67 158.89 3 476.67 C003260 0-9-76 STREET RESTOR. GRADING 1974 $37.67 $7.53 5 PAID q% SAN SEW TRUNK 1974 $65. 31 $4. 35 15 PAID * SEWERLATERAL 1976 3 WATERMAIN * WATER LATERAL 1976 3 * WATER AREA 1976 3 *313STORM SEW TRK 1976 $1628.80 $542. 93 3 PAID STORM SEW LAT 1976 3 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 1763 12-5-75 BUILDING PER. 3808 1763 12- - SAC 1763 1 - - PARK 100.00 CITY OF EAGAN Remarks wea Addition Woodgate 3rd Addition Loc 28 sik 1 Parcei Owner S reet 1712 Woodaate Ln. State Eagan, MN 55122 , - ° VL 1701 tOlLt t;; -r',P-; 55 3 39 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 310 STREET RESTOR. GRADING 1974 $37.67 $7.53 5 PAID SAN SEW TRUNK 1974 $65. 31 $4.35 15 PAID * SEWER LATERAL 1976 3 WATERMAIN * WATER LATERAL 1976 3 * WATER AREA 1976 3 I* 5.1TO SEW TRK 1976 $1628.80 $542.93 3 PAID ie j4STORM SEW LAT 1976 3 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. $160.00 1763 12-5-75 BUILDING PER. #3808 sac 425 00 1763 12-5-75 PARK lOO.OO CITY OF EAGAN Remarks ~ Addition H1ood a e 3rd Addition Loc 27 Rik 1 Parcel Owner Street 1714 Wood$ate Ln. State Eagan. MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. 110 1977 476.67 158.89 3 476.67 C003261 0-9-76 STREET RESTOR. RADING 1974 $37.67 $7.53 5 PAID 'a SANSEW TRUNK 1974 $65.31 $4.35 15 PAID * SEWERLATERAL 1976 3 WATERMAIN +t WATERLATERAL 1976 3 i* WATER AREA 1976 3 *NSTORM SEW TRK 1976 $1628.80 $542. 93 3 PAID I* STORM SEW LAT 1976 3 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. $160.00 1763 12-5-75 dUILDING PER. #3808 1763 2-5-75 sac 763 12-5-75 PARK E GEO. SEDGWICK HTG. & AIR COND. CO. ~3 3 Jc.~S HOUSE HEATING TEST RECORD ADDRESS ! 7" UUck~L' CITY OCCUPANT OWNER HEAT LOSS DATE HTG. INST. SOLD BY ~ 0 3 INSTALLED BY Electrical Work By Gas Line By c f~ ' TYPE OF HEAT GA_ FA-Z- HW_ STEAM SPACE HTR. UNIT HTR. OTHER GAS DESIGN ERSION MAKE '1--C'r'1 /1 V X -MAICE.QF BURNER ID Model (1--) J 4~ Q?-~fiG Model " ~ Serial Max. BTU Rating INPUT ~'0 0D0 1\11AKE¢E-FHR117KC-E Nfodel ' CONTROLS THERMOS AT-- ~6 - Heat Plug Vent Size x Valve e T S , KIND OF LINER SIZE NONE Limit A on w Draft Hood 4'C' < Regulator J'`1~•'~ ~ LimitSetting_- aoU 0f Filters Size Number Fan Setting -/DO °f Chimney Location lnside Outside PilotType I r, ~ 5ChimneyConstruction_ c-~~5`> Pilot Make - ~-EN1U0 X i Pilot Model 2L -l 0 S- Smoke Bomb ' Wiring ~K Pilot Timing 74 wf Draft ' Test Tag L.W. Cut Off Door Pressure - Lighting Inst. 0 Pressure wc . Percent C02 • S/O Date Tested Input CFH Percent O 7 ' 0 Company Testing G • ~ K 1 Stack Temp. Percent C02 t-'"l~ Name of Tester-~ j e!' Form 235 lf`BUILDING PE UATE: 6/20/91 SITE ADDRESS 1714 WOODGATE LANE Unit # Permit AM FTG' S ONBW L 27 B 1 Sect./Sub. WOODGATE 3RD HOMEOWNER* r _ _ _ CONST.-432-5270 INSPECTION INSPECTOR DATE COMMENTS C,k- TER DA .j INSPECTION INSPECTOR DATE COMMENTS PERMIT # MECHANICAL PERMIT RECEIPT # CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: CONTRACT PRICE: PHONE: 454-8100 - Site Address OG VG ;`F /'J 10F gLDG. TYPE WORK DESCRIPTION ~ Lot ~Blonk ~ S~c/Sub Res. ~ New ~ r~- ~ Name Mult. Add-on ~ Comm. Repair Address , ~ City 'SII~KGPf F Phone Other ~ Name ~p f /5 FEES RES. HVAC 0-100 M BTU -$24.00 3 Address ~r ADDITIQNAL 50 M BTU 6.00 O CitY Y~~ L f f Phone V:5 ..a (RES. HVAC iNCLUDES A/C ON NE1N CONSTRUCTION) GAS OUTLETS (MINIMUM - 1 PER PERMIn - 1.50 EA. TYPE OF WORK COMM/IND FEE - 1% OF CONTRACT FEE Forced Air J~;M gTU APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE & CONDOS - RES. RATE APPLIES Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON & Unit Heater M BTU REMODELS - 12.00 Air Cond. M BTU MINIMUM COMMERCIAL FEE - 20.00 Vent. CFM STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES Gas Piping Outlets # BEYOND $1,000) Other ~ FEE: C.,~ 't~ E1 ,f ' F S/C: SIGN UR =F1 E TOTAL• x' ee- /X-7 ~ FOR: CITY OF EAGAN . . Receipt MECHANICAL PERMIT Permit No. I0" CITY OF EAGAN Fee Fill in numbered spaces S/C Type or Prini /egibty Tot. J~`~ U 1. Date 2. Installation Cost i J 3. Job Address ~Lot a Blk. Tract ~ 4. Owner . ~ - ~ ~ ~ , • ~ , 5. Contractor Phone ~ 6. Address "Z" y 7. City State %Zip 8. Building Type: Residential ~ Commercial ? Institutional ? 9. Work Description: New ? Add ? Alier ~L9 Repair ? 10. Describe r G Fuel Type ~ 11. No. Equioment BTU - M. Ea. No. EQUiament CFM Forced Air Air Handling: Mfg. Boilers Mech. Exhaust Mfg. Unit Heater Mfg. Other Air Cond. Mfg. Gas, Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with;all ordinances antlcodes governing this type of work. Signed: for Rough Fi a Inspections: Date Insp. Date nsp.v&./ This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 Receipt % + ) PLUMBING PERMIT • Permit No. CITY OF EAGAN ' Fee ~fill in numbered spaces S/C Type or Print /egib/y Tot. 1. Date 2. Installation Cost 3. Job Addressl~'~ Lot Blk.i Tract 4. Owner 5. Contractor Phone ~ 6. Address f ~'r~ ~l f h ' , 1' 7. City State Zip 8. Building Type: Residential ~ Commercial ? Institutional ? 9. Work Description: New ~ Add ? Alter O Repair O ~ 10. Describe 11. No. Fixtures No. Fixtures ~ Water Closet Cesspool/Drainfield Bath tubs Septic Tank Lavatory Softner Shower Well Kitchen Sink Urinal/Bidet Other Laundry Tray Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 I rs INSPECTION RECORD ~ CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: ~ ' ~ ~ ~ ~ (612) 681-4675 SITE ADDRESS: ` 0 t` 'l APPLICANT: I I:i F c i 131, !1l t' ~ 1100t3t3A'1`f' i APfl r. t r;~~ ~~~rJ~, ? PERMIT SUBTYPE: TYPE OF WORK: I~! i j 1 i+Fl t!:rl ? II!r+>>tf+i 's INSPECTION DA • DATE INSPTR. 1 1, a!h? I Nl: 1~l1l16i! I!N 1,1 1;:, iiUt{;{ 10 ti iji ! 1 tJA! I „ s + W~r~~~ w_~.- Permit No. Permit Holder Date Telephone 11 ELECTRIC , yrz 9 ~ 0 ~ PLUMBING HVAC Inspecrion Date Inip. Commants FOOTINGS FOUND FRAMING [ ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYPBOARD FIREPLACE I FIREPLACE I AIR TEST FINAL PLBG Q~w FINAL HTG ORSAT TEST BLDGFINAL BSMT R.I. BSMT FINAL DECK FTG DECK FINAL INSPECTION RECORD C Y OF EAGAN PERMIT TYPE: 30 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: ~ (651) 681-4675 SITE ADDRESS: APPLICANT: d kll . j PERMIT SUBTYPE: TYPE OF WORK: INSPECTION . .A ~ ~ i ~ ~ 'i ~ - I Pertnit Holder Date Telephone if I WA ER I PLUMBING I I HVAC I Inspectlon Date Insp. Commenb I I FOOTINGS I I FOUND I I I I FRAMING I I ROOFING I ROUGH PLUMBING I I PLBG I AIR TEST II ROUGH I HEATING I GAS SVC I TEST INSUL I GYP 80ARD II FIREPLACE I FIREPLACE AIR TEST FINAL PLBG FINAL HTG I ORSAT I TEST BLDG FINAL I I DOMESTIC I METER I IRRIGATION I METER I FLUSH I MAINS I CANDUCTIVITV I I TEST I I HYDROSTATIC TEST I BSMT R.I. I BSMT FINAL I I DECK FfG DECK FINAL C INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number. Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 I SITE ADDRESS: APPLICANT: f~,r ttI t,i; a T'dl';nr.,'r! ; t111~1': ! M(" 1 t.t:t i ! PERMIT SUBTYPE: TYPE OF WORK: I, r,t~ t INSPECTION DA • DA w r i 4~Et~f: i T1~, ` 1 J 1 41 ! 1 rt i ) ! I I:' F t i~ } t,` L/0 ( 1 tf i 171tflMfA i f ! 14 ~ ~ ~ Permk No. Permit Holder Date Telephone 9 ELECTRIC PLUMBING HVAC Inspection Dats Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE i AIR TEST FINAL PLBG I I FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FfG DECK FINAL - - - ~ VIL-L11Gt CF EAGAN WATER SERVICE PERMIT 3795 Pilot Knob Road ' PERMIT NO.: 1901 Eagan, MN 55122 DATE: 12/12/75 Zoning: RII No. of Uuits: 4 Owner: Ne orizon Homes Woodgate III i~ddress: 7- l L.v(1L.).C(<: fa 3/"'!' Sice Address: 1 10-12 14 Woo gate Lane Plumber: Z'1'iompson Plumbing Co. Meter No.: Connection Charge: 640.00 pd Size: Account Deposit: Reader No.: Permit Fee: 10.00 billed I agree to comply with the Village of Eagan Surcharge: • 50 billed Ordinances. Misc. Charges`.!?00" 00 / Total: BY Date Paid: Date of Insp.: Insp.: VILLAOE OF EAOAN SEWER SERVICE PERMIT 3795 Pilot Knob Road PERMIT NO.: 2658 Eogon, MN 55122 DATE: 12/12/75 Zoning: RI I No. of Units: 4 Owner: New HOrizon Homes 4Joodqate III Address: Site Address: 1708-10-12-14 Woodgate Lane Plumber: Thompson Plumbing Co. I ogna to eomply with tbe Villoge of Eagoe Connection Chazge:1700.00 pd Ordinaness. Account Deposit: Permit Fee: 10.00 billed Surchazge: • 50 billed By: Misa Charges: Date of Insp.: Total: Insp.: Date Paid: 2I~ C n(~'t~ ~ OFFICE SE ON Y This request void 18 months from volidafion date printed in ihis box. L ~t PLEASE PRINT OR TYPE a ~ Requeut Dafe Rough-in inspedion required2 VY ? No Inspedion Other Than Rough-In: Ready Now Will Coll , / 9s (You must coll fhe inspedor when ready) Date Ready: I, ~j licensed contractor ? owner hereby request inspection of the above electrical work at: Job Address (Sireet, Box, or Route No.) Ciy Zip Code / G{ Q,-W ct.n.¢J a Secfion No. Township Name or N. Range No. 4reo Coun 12 (C_4 t"IOccup,nt Phone No . i Address Eledrical Coniracfor (Company N )A Contrador License No. Master Lic. No. (Plan} Elect. Only) ~2[CJ ' Moiling Address (Confrac^for or Owner Performing Installation) ~..Jb-k4z_ Authorized Signafure (COform ing Installation) Phone No. /51 p EB-000OlA-10 /95 STATEBOARDCOPY- SEEINSTRUCTIONSONBACKOFYELLOWCOPY Jill I~ REGIUEST FOR ELECTRICAL INSPECTION Minnesota State Board of Electricity ~ . llllllllli I 1821 University Ave., Rm. S-1 8, S Paul, MN 55104 0 2 &214 7 6 4 1* Phone (612) 642-0800 ome up ex Apt. Bldg. Other: New Addn Commercial Industrial Farm Remod Re air ,4ir Cond. Htg. Equip. Water Hir. Load Mgmt. Other: D er Ran e Elec. Heat Tem . Service "k' above the work covered by this request. Enter remarks in this space and on the back of the white copy only. ioww_m Calculate Inspection Fee - This Inspection Request will not be accepted without the correct fee: Ofher Fee # $ervice Enfrance Size Fee # Circuits/Feeders Fee Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps $treet Ltg./Traffic Sig. Above 200 Amps Above 100 Amps Transformer/Generator INSPECTOR'S USE ONLY ~ T TAL A, Sign/Outline Ltg. Xfmr. 46) • f_ Alarm/Remote Contro $wimming Pool I hereb certi that I ins ecied the eledrical insta on escribed ein 1n th dates stated Irrigation Boom Rough-In D te / Special Inspedion • ? Investigative Fee Final Te T/ THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF N L WINTHS. This request void ~/o~ 18 months from D 13 5 6 0 6-0 Re.qLtasrlUatiii,, I-Fire No. /lRouph-in Inspectwn ~ Required? ~Ready Now Q Will NoUfy, Inspec- [or When Ready 7-9-87 ?Yes (Y~ No ]a Licensed Elec[rical Contractor I hereby request inspection of above ? Owner electrical work installed at: Stre~t Address, Box or Route No. City 1710 Wood ate La. Ea an ec1,_,o7o. Township Name or No. Range No. Counry Dakota Occuuant (PRINT) Phone No. Kurt Streets 452-4173 Power Supplier Address Dakota Co. Ele. Co. 14300 220th Str., Farmin ton Electrical Contractor (Company Name) Contractor's License No. Total Electric, Inc. 039842 4 Mailing Address (Contractor or Owner Making Instailation) 1537 92nd La. NE, Mpls., Mn. 55434 ne Number Aut Signature (Contrac or/Owne Making Installation) 7786-8484 MINNESOTA STATE BOARD OF ELECTRICiTY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room N-191 BE ACCEPTED BY THE STATE BOARD 1821 Universitv Ave.. St. Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0800 ENCLOSED. ,211 REQUEST FOR ELECTRICAL INSPECTlON .r.. Ee-ooooi-os ~l Il, See instructions for completing this torm on back of vellow copy. 3-5'6 0 '"X" Below Work Covered by This Request Navw Add Rep. Type of Building Apptiances Wired Equipment Wired Home Fange Temporary Service Duplex Water Heater Liyhtin,y Flxtuies Apt. Building Dryer Electric; Heatni ` Commercial Bldy. Furnace Silo Unloader • Industrial Bldg. Air Conditioner Bulk Milk Tank Farm Other pecifY Other (Sper.i(y) t c ar Succifv Other 01he, ompute lnspection Fee Below q Fee Service Entrance Size Jt Fea Feeders/Subfeeders # Fee Circuits U to 200 Am s 0 to 30 Am s 0 tn 30 Am s Above 200 Amps31 to 100 Amps 31 to 100 Am s Swimming Pool Above 100_Amps Above 100_Amps Transformers Irrigation Booms Partial-'Other Fee Signs Special Inspection S Rerr~rks 10.50 TOTAL E • Rough-in Date I, the al Inspector, he.eby certify that the above Final ~ insPection has been ~ made. This request void 18 months from CITY .OF EAG1J~ - 3795 Pilot Knob Road 41 ~ Eagan, Minnesota 55122 77/ . Pi1~= NOa : 780 . Tne Ci-L-y of Ea.ban he.reby gr. ?nts to Geo. SedcJwick Heating ` Of 1001 Xenia Ave. So. a H,FATING Permit for: ((haner ) New_Fiorizon - Wo6dgate at 708-1.0-12-14 Lloodaate Ln, PursuatrL-i to appl~cat_or da teci Fee Paide ciated this 23 , -da.,,- oi' „ P_ec. 2:00 s/c Builciing In4.ne,~tbl- Mechanica,l Permits: Bici Tota.l: 3 ' ' CIi''l C7, an,r;-,;c, ?1 ~_~ji .I;Y?C'b _ L'•.~::.` .._..'.1+:__ Jt~i. i'..22 Vv v . ~ lJ~-'` 1 i.,:_ ~ --~1-------- `i:~e Ci ty -•y to Thompson Plurak.ing Co. r 12201. Minnetonka Blv,!^_ N~+ a PLLTDURI*dG Pe,•m,it for: (C~,,J_,=r. j New Horizon - Wooagate TII 4443-45-47- ~1~3Q-e1_Sq~dqate Pt., 1724-26~Woodgate I,n, 4468-70-72-74, 4469-62-64-66 Al 5 2 -5 4-5 6-S.3, ~ ~~~~.Pi~~3gU...;_,1~,9h-98, 1700-02-04-06, 1708-10-12-].4,171F.-]_t?-2r1-??i-3 T? _ ttf , f • --Woudgatre Pt. ~lC..~ ~5 v ~ m o i ee f,ed tY1:i_s 12 75 Billed: ~--a, of ~ r~'•~- d ~2Q-rP.~OG.^./c _ . .,,11 . _ CIP.r 0.^ P~_~G.N I'i].ot Y-noU F'.oaci Ea,c-lan, Ninn,~sotua 55122 , • FERN!IT P,TO s : 40 . T'_;c CitSr oi Ea.gan hereby grants to Commers Soft Water_ Co. v; . ncar, D. s~•:enson ancT~~ y ~Water Softener per ,ner B. Stuart - _ - - . , 1710 Wood ate Lan an Pu?^suant to appl_ica.t-on da-~od ~ 5/25/76~---- r::~' c?~,ted -this -.77_ da.y of _ ---MaY 6-= I.SQ s/c L-:ui~~.ing TnSN9c: G,) p r ~ t oI'mj.+So ~ - ` ~ 7/0 1-1" ci~-y u.r-_.;~~ . j 6 g5'b c~ ~046 ~ i ~i j j~ ~7 IiY1C~ ~~ii~;Ci ~ Ut~i. J 1 ~Oo~~ y~~~ ! - . C _ ---fiAl--•-----_ :111) e Ci tv u:~ 1~ar;,~r, }lcr::,•Y , r~.,, to Thompson Pluunk;ing Co. 12201 Minnetonk.a blv? . a PLtT*'R3I`1G Pe-mit fo?^; erj New Horiron - Wooclgate IIZ 4443-451~17-~:!~, .443~1-a_1. taoodgate Pt., 1724-26-Woodgate I,n, 4468-70-72-74, 4469-62-64-66 A-45?-54-56-5? ~'!p~ , - p*'~Q«9?~ •f~A~~~i~•_1700-02-09-06, . . _.i . , . . - p e mo Ft. ,cd this 1"L c:av n^ De.c. 75 Billed: r/c- - - d- - L1_LC~in"' 1`.1; -C i•UL-- f.c =._aL.i C<., I_ S: . .,~.1 : Cities Di i~l Qualitv 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. . ~ . -cITx. oF Eac..A.~~ • ~ 3795 Piiot{, :ob Road Eagan,. Minnes,ota 51~' - 'Y"~~~ ;~a . ~ ~ 'ey!%~i ~ • g~~S "F°~ 4 i ~ ~~•.;.~,g~ L~~, ` g e~.Y•~~ . ~W~ A. PEFMT : ~.y ~ f ~ ~,~J • a.~ Ciyty of Eagan he.'reby gr?nts to Ci 1001 ~ Xea a ve. a tIEATING Permit for: ((haner) New_Fiorizon - Woodgate at .ap~ /a\o_i 2-14 Woodaate LIl, Aursuant to applicat_or: c3a,teci 12/7,5 ~.s F'ee Pai(i: cia.ted this 23 day of _ Dec. ~ 19` 75 . 2.00 s/c I3uilding Inspc,.;tclr• Mechanical Permits: Bici Total: . ~ ` cT,.:r GJoocJ~ ~ 3 j 9 J Kn _~b ta~„ri ~ Z) 5W6do2 oZ' ~ 0/ Jtc;. ~J l~ ~2 ID~~Y7~Q6~~ ~ ( ~V ~.C.X 1'._.t _ _1 _ . . ~-~1--'--- - I'i)e '-'i ty o:~ 'Jar-nr: ~F, to Thompson Plar~~k.ing Co. 12201 Minnetonk.a Blv:l _ , . - - a PLLTD'II3I`dG Pe>-,,,it fo?^: (~,-,_~r. 1 New Horizon - Woodg.te TII - a 4443-45-47-~l~, 4439-Q1 tqoodgate Pt., 1724-26 Woodgate I,n, 4468-70-72-74, 4469-62-64-66 ~A,452-54-56-5S , 1700-02-04-06, . ~ 1708-10-12-1171F-1 R-2.n-7.2 ~--A , , . - , , pt. i ce d thiS I<- ;t:z;r oT~c. ~ 75 Billed: ~ 2~?p r%c- ~ - - ~ _ . 1 Cities Di ital 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. CITY.OF EAG:J~ ~ 3795 Piio"t'~. Knp,b Road Sap, Minneso~`at5a _ ~ E.,~IE , ..,T, ~5~4' ' ',~~s~,-~'"~ ,f~~~`.6:,, 6~~`" - .~,1 • . " i ~ ..&kkyt ` t , _ • . . ~ ~ i ::.w~-! j . . ~ . . P i'~N1I'~` ~r . `I r '.k~•. `g ' . ~q .~~;`'Fr.1~r' .-v+~vr' ' ' ' .'vAg .."e ty of Eagan he.reby grQn.ta to • N, ^z 1001" Xeni a HEATING Permit for: ((haner) New_fiorizon - Woodgate at ~p,'1-10 412~14 tdoodgate Ln, Pursuan-i, to applicat_or: dateci ~ Fee Paid: c;a.t;ed this 23 dac oi _ T)ec. . 2.00 s/c Building Inspcctol- Yiechanical Perm-ii.;s: Bici Total: .3 ~ ~ 6-0 . 1... L . ~j ! ) I' ~.Gl,~ K:'1 O U Fiewad • ra,~ zti, r~inncso--~~. 551 22 PEPNIT N0 > :_22__ T!ie Cit;T o~ E.~.~an her-by gr~,~ii,s -L-o _C%um,pr8- s~ft Water re_ L. J. Haake, L. D..?Fanlund, J. S. Oricchio, :L __WATEB_SQFMIxr•.r~_ Permi_t i'oro (Cwr_er) - 'zS"': :`Yl'% rzre, 1392 Amaryllis Lane, 1334 Easter Lane and F-.': .~a-MAI-M-, - - pursuu_i-- -co a~:plic ~-~.;ion da-~ed ?t/2/7F 7 i .r~ ~.1._jtllJ d~ R/n-~ • n (&.ted thig ~g. ciay oi _sprit ~.y ~ ZA j For Office Use ( O{ Eapn permit b 3 I~ 1 1 Pertnit Fee: 3830 Pikyt Knoe Road Eagan Phone-M(65~675-5675 ~ Qase Receivrea: Fox: (651) 675-5694 i stan: 2008 COMMERGIAL BUtLDiNG PERMIT APPLICATfON Date• Site Address• ~ YV, Tenant Name: (Tenent is: - New / 5xisting) 3u PROPERTY OWNEFt Hame: Phone: Address / City ! zip: Applfcant is= Owner ContracDor TYPE OF WORK Description of wortc: Gonstruction Cost_ CONTRACTQR Name: _._.L* ()Ob~MNO License Address_ 5141 PEARSON P1CWY City: ANNA763.56a'1i97 State: Zip: Phone: _ Contact Persqn_ ARCNITECT I Name: Registration FNGINEER Address_ City: Srate- Zip: Phone: Contact Person: Lioensed plumber inSta{ling rgm sewer/wster servioe: Phom NOTE: Plans and supportlng cldcuments that you submlt are cvnsidered b be publlc fnforn,ation. PorMns o# the inlnrrnatlpn mgy be classJfled as non-public if you proWdb specli"'c reasons that woL/d pernl/t the Cfly to concluae that tre am trsde secners. 1 hereby dCktlOwtedge that this irifortnation i& complete and accurate: ihat the wotk wHl be in confortnance wlth the Ordinances and codes of the City ef Eagan• that I untlerstand this is not a parmlt, but Onty 8n application for a permit, and worFc is not to start with0uf s pertnit; that the work will be In eCCOrdarux:e with the approvad plsn in ihe case ot work which requires a reviow and approval of plans. x b( x ApplicanYs PrlMed Name Applican ' Slgneture Page 1 of 3 bT/80 30dd 0-10-13 dNNd LEbEE05E9L 96:ZZ 80aZ/6Z/60 ANDERSON 20P8-09-V 15:52 ANDERSON 6513881098 » 651 675 5694 P 1/3 CAA:)- Z41 , ~ of Eaian Parmft Dtl { ~5 ~ 3$30 Pllot Knob Rosd Partnlt Fee: ` Eagan MN 65122 7 i DaW Rsosivsd: i Phone; (551) 675-5675 V Fax: (651) 875-5694 LMO ~ stan: i , . L-nlC~-cT 2008 COMMERCIAL BUILDING pERMiT aPpLIcaTIoN SI I~?C~ 1'?f ~ 1-7 IZ S!l i~~i~Ib~ID~T~' Lta ~ tsnant Nsf11s: - (Tensnt !b: New / , Exlstlng) Stilte t: 6 PROPEFtTY OWNER Name: Phone: Address / Gty / ap: 4 1 AppllCant is: _ Owner & ConhBCtor rrPE oF woRtc oes«iptio, orwork: zu _ _ Co,~o, ~t: CONTRACtOR l.icense • ,4ddress*aS~' ciry:. ~ A~Ar?L_ ssace: Zip: w,one ; ! 14e i concacs aomon- ARCHITECT / Narne: Reglstrauon Ik: ENOINEER Add?ess: CitY: State' Iip:, Phone: Contact Person: Uoenmd p{tHrlbsr instaNing r,v sswer/water service: Phone t: N07E: PUM and support/n8 dvcumenis fhet you subm/t aro oonsldWed to bv ptibffc Mkwmflan. Porb" of Nre lnlbn»atlan rrray be clsas/Ned as aonyvublic N you provlds spec!!Nc roasons thst would permlt dw Clty tv cortclude thst LhSZ aro rixdis secrets. I heroDr aduww+edpe tnat mis lMOnr+atla+ fa comdete and aocurate: met u,e +nwk will be k+ cont«n+a?ae ancea ano oodss of etre cuy a F.ap811: tfiat I understand thie Is not a psrtnil, but only an epplication fo. 8 Psm+x, and rwt to ata A pe~R; that fhe work wiq be in aocwdanc9 wlth ihe at~lx~oved plan In tho caas of work h roquireg a review and of . ~ X AppNoonYs Prlnlld NOIM ~~PP~~111! $idna[YnP Page 1 of 3 . 2008-09-12 15:52 ANDERSON 6513881098 » 651 675 5694 P 2/3 , . . 1 • A American Family Insurence Group WOODGATE_III_HOMEOW9 •Building Exterlor RooFiag DescriPtion Ba?se Service Replacement Actual CaeA Qty Unit prlce Charge Taxts Cost Total Depreriation Value Ths jollowing Itsms ref I'ect replaCemenl q/'roof oR tlus structure. Insured indicatsd roof ir epprorimalely ]0 years old Bdsea op dverage conMon and ljfs ezpeceancy oj30 years, 33Yb depncialion har beeh applted Prlce lacludes debNs romoval. l- Remove Tcar of'f, haul and dispose of comp. chingles - 30.40 yttv 46.57 SQ $30.96 $0.00 $0.00 $2,373.21 -$783.16 (33%) $1.590.05 2- Replace Roofing felt - 15 ib. . 46.57 SQ $19.71 $16.93 $18.34 $953. ! 6 -S30B.95 (33%) $644.21 38 - Remove Additional charge for high roof (2 stoiies or greatcr) 46.57 SQ $4.43 $0.00 $0.00 $20631 -$68.08 (33%) 3138.23 3n - Replpce Additional chargc Cor high roof (2 stories or greacer) 46.57 SQ 511.39 $9.79 $0.00 $540.22 -$175.04 (3396) $365.18 4- Replace Flsshing - pipe jack 4.00 EA E23.19 $1.71 $1.57 $96.04 -$31.13(33%) $64.91 5- Replace Roof vent - turtle type ' 13.00 EA $36.05 $9.97 $12.83 $363.35 -$182.68 (33%) $380.87 6- Replacc Exhaust cap • thmugh rcmf 4.00FA $64.98 $4.60 $8.64 $27336 -$88.63(33%) $184.73 7 - Rcplacc [cc & watcr shield 1,337.cx)SP $1.33 $33.29 $51.28 $1.889.52 -$612.55(33%) $1,276.97 8- RcpIsce F7ashing. 14" wide 30.00 LF E2.68 $1.49 $2.55 $84.44 -$2737 (33%) $51.07 9- Replace Chimney flashing - averugc (32" a 36") 2.00 EA $209.72 $7.73 $5.47 $432.64 -$140.22 (3396) $292.42 I U- Replace Lamineted - 30 yr. -comp. shingle rfg. - w/out felt 53.67 SQ $149.69 $148.20 $237.85 $8,419.91 -$2,729.66 (33%) $5,690.25 11 - Replece Ridge csp - composition shingles . 136.75 LF • E3,15 $7.95 $6.76 $445.47 -a144.38 (3396) $301.09 TotalS $241.86 E345.29 S16,277.83 -S5,291.85 $10.985.98 Guttery/DownspoutR Descrlpt[ou Bese Service Replacemept Actuxl Casb Qty Udt prlce C6arBS Taxes Cost Total Depreciatbn Velue WOODGATE IIi HOMEOWNERS 00311284570 7/21/2IX38 Page: 4 ASSOCIATIONS MECHANICAL (RESIDENTIAL) 3c) Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 Please complete for: Single Family Dwellings Townhomes and Condos when permits are required for each unit Date -:7 0'3 Site Address ~ cj Unit # I ~l L a~ ~ Property Owner a~ I Telephone # Contractor ry~ ~ -r W ~ ~UUJ QI.1~,, Street Address 24260 Greenwa~~ A~~e. Suite E City Forest Lake, MN 55025 State Phone 651-982-2626 Telephone # ( ) ~ J The Applicant is Owner Contractor Other Add-on, modification or alteration to existing dwelling unit $ 30.00 -L---furnace replacement _ air exchanger ~r conditioner other State Surcharge $ Total N~~~ C I~ I' I~ $`7` AU ~ ~ I hereby apply for a Residential Mechanical Permit and acknowledge that the info tion is complete and accur te; that the work will be in conformance with the ordinances and codes of the City of Eagan and with th echanical Codes:_tlunderstand this is not a pernut, but only an application for a pernut, and work is not to start without a pernut; that the wor w~n accordance with the approv plan in the case work which requires a review and approval of plans. .Q~ Applicant's Printed Name Applicant's Signature MECHANICAL (COMMERCIAL) Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 Please complete for: commercial/industrial buildings multi-family buildings when separate permits are not required for each dwelling unit Date Site Address Unit # Tenant Name (if applicable) Previous Tenant Name Property Owner Telephone # ( ) Contractor Street Address City State Zip Telephone # ( ) The Applicant is Owner Contractor Other Work Type _ New construction Underground Tank _ Install _ Remove _ Interior Improvement Call for inspection during installation/removal of tank _ Processed Piping Nature of Work: Permit Fee $50.50 Minimrrm Fee (includes State Surcharge) Contract Value $ x 1% Pernut Fee • If permit fee is $1,000 or less, add $.50 $ State Surcharge If pemut fee is over $1,000, add $.50 per $1,000 Permit Fee $ Total Fee I hereby apply for a Commercial Mechanical 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 with the Mechanical Codes; that I understand this is not a permit, but only an application for a pernvt, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Applicant's Printed Name Applicant's Signature Approved By: , Inspector Date: ?X7'i'. k~~C7~l~i)~ )}:%i ~CM~( Y{>it?X>d7X~ ~~i{ Y{:)"j.'t~C}~C )~C)'t~.?}: )~1~ )it~: tit)~C ht i'(,s;C7;C?',C K (,.C'fY ClF IH.-.Af,•v(1\f (::Af:i4°I:I:ERn s:i E'E{"tM:C NN._ NO° 778 Itf11'E: :1.4:1/2a./98 T:l:ME' :1.:1.^OWCl ID Nt-1NiE: n S! atjur:BnN 6f4C71)f' :1:NC 205 `?()Oi. 126.00 3210 9001 :L'i QE:3 1AIO(:IDG;FI,('C•:: L. r":?E,i.'. A i:.'.5 32iG 9001 4492 HOr.rr..Er_..ATE P 2Er2,.2; 3210 9001 0"36 W{:1C)11(:;11YE 262o25 32:I.O 900i 1716 Iblf)(:jDi;,(•1Ti-: L. 262w i?5 32:I.CI 9001 4476 Hf:lClDG(1Tl::: P 262.c?`; ::',r i..t:l 9001 446£3 WCl(:]DCr11'E F' 262.25 320 9001 4452 HC)ODG;F1T'E P c?F:,c?e%.'.`:i 320 `•??.JtJ:. 4484 IAI(:if.)DGf1T'E f-' i?t:,{ v25 3210 9001 024 l1dC1C1Di:;f1T1::: L. 26205 GR098584 C:i]N"f:CNtJE ?.J;:,ER :Cria NANt',7' A;i< C()NT':I:NLiE:: C:C.INT7:Ni..1E C::I:T'Y ()F° 1EAt:,FtN fwASHl:i:::l1:, S 'T'I:::FiM:CN(-tl._ NOC 778 L't1'T:::t 1(:)/21./9f3 T'TM;:::n WC)043 iDs NnMcu taUr{URBAr.! r.,rti.r.»Ur• a:Ncs 320 9001 4451 IxIC1fJDC(1Y'E_ f' 262.25 320 9001 4443 HOODG~ TE P 262a 2il 320 9001 03(:] PIfJ(']DG(al"f::: 262„25 320 9001 V44 Nar_)ODt:,A1"E L. 262.25 ,:3£-'_:I.t:l 9001 4460 HO(:lD(;;AT'!:_ P 262.25 iOt%.1.1. Ftt:•)ceipt (1mC7+.:Ylt; u 3;797.50 GFi098ifi34 1.Jw;i:::l : :i:Du NAN~..",Y r, V PERMIT CITY OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G Eagan, Minnesota 55122-1897 Permit Number: 0 3 3 7 4 8 (651) 681-4675 Date Issued: 10/21 / 9 8 SITE ADDRESS: 170$ WCIODGAT'E L.ANE LpTe 25 BLOCK: 1 WOOCIGATE 3RCl P. 1' . N e: 10-84602--250-01 DESCRIPTION: T . o e & R E R 0 0 F/ A- P L E X )(VN-n1' c- . Bua::ldiric~-_Permit Type Building Work 7ype \-13\,ARENAIR ;G ens u s Code ~ 9-W- AL-r N„NR E S. J\~)~v'~-~ . - ~ i , , ~ , C- ' --C) -1- L REMARKS: INCLUDES: 1710, 1712, AND 17:14, FEE SUMMARY: VflLUAT,T.(]N $1$,000 Base Fee $262.26 S u r c h a r g e 9,a Po. Total Fee $27:1, 25 CONTRACTOR: - APplx cant - OWNER: 5UF,.URBAN EXTERIORS 28818232 WOODGATE ASSOCIATION 9701 PENN AVENUE 50UTH 1708 WOqDGATE LANE BLQOMING70N MN 55431 EAGAN MN 55122 (612) 881-E3232 (651) I hereby acknowledge that T have read this applieation and state that the information xs correct and agree 'Co comply with aJ.l applicabl.e 5tate af h1n> Statutes and C3.ty of Eaqan Ordinances. APPLICANT/PERMITEE SIGNATURE SUED BY: SIG ATURE 1998 BUILDING PERMIT APPLICATION (COMMERCIAL) CITY OF EAGAN 681-4675 Submit following to obtain necessary permit Foundation Only New Construction Interior Improvement structural plans (2 sets) architedural plans (2 sets) architectural plans (2 sets civit plans (2 sets) structural plans (2 sets) code analysis (1) code analysis (1) " civil plans (2 sets) project specs (1 set soils report (1) landscaping plans (2 sets) Key Plan ~ project specs (1) code analysis (1) " energy calculations (1) not aMrays " Special Inspections 8 Testing Schedule soils report (1) Electric Power 8 Lighting Form (1) not aM+a ys « SAC determination letter from MCIWS - SAC detertnination letter from MC/WS - SAC determination letter from MCIWS - call 602-1000 call 602-1000 ca11602-1000 Special Inspections & Testing Schedule (1) " project specs (1) energy calculations (1) " Electric Power 8 Li htin Form 1) " Contact Building Inspections for sample Food & Beverage or Lodging facilities: Plan must be submitted to Minnesota Department of Health. Call 215-0700 for details. DATE: I C-) - L~ WORK TYPE: NEW REMODEL DESCRIPTION OF WORK: CONSTRUCTION COST: GOG TENANT NAME: > »~y SITE ADDRESS: 2. SUITE . LOT aS BLOCK ~ SUBD. W C~ 3 r~ P.I.D. # Name: w~~ ~ ct.Q2 Phone PROPERTY Last First owrrER Street Address: Ciry ~Ce~rC:QM State: ~lvn Zip: Sc~ 1 Company: SC'b v'rY,<"M i c1 f S Phone V8~-<(RS 2-32 CONTRACTOR C; Street Address: G-zo1 PQy'ln AlJ-e ~ License # 4z-S nJ City ~ ~CXl~ State: A4 c.--~ Zip: S'S-f 3 ~ ARCHITECT/ ENGINEER Company: Phone Name: Registration Street Address: City State: Zip: Sewer & water licensed plumber (only if installing sewer & water): I hereby acknowledge that I have read this application and state that the infoRnatio correct and agree to comply with aIl applicabte State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: ~ OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation O 19 Comm./Ind. Misc. ? 21 Miscellaneous ? 18 Comm./Ind. 0 20 Public Facility WORK TYPE O 31 New O 33 Alterations ? 35 Tenant Finish O 32 Addition 0 34 Repair ? 37 Demolition GENERAL INFORMATION Const. (Actual) Basement sq. ft. MC/WS System (Allowable) First Floor sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinklered Zoning sq. ft. Census Code # of Stories sq. ft. SAC Code Length sq. ft. Census Bldg. Depth Footprint sq. ft. Census Unit APPROVALS Planning Building Engineering Variance Permit Fee Valuation: $ Surcharge ~ . U U Plan Review MC/WS SAC City SAC Water Conn. S/W Permit S/V1l Surcharge Treatment PI. Park Ded. Trails Ded. Water Qual. Other Copies TotaL• % SAC SAC Units Meter Size ~ y PERlliIIT CITY'-OF EAGAN BUILDING 3830 Pilot Knob Road PERMIT TYPE: 0 2 9 7 7 6 Eagan, Minnesota 55122-1897 Permit Number: (612) 681-4675 _ Date Issued: 04/21 /97 SITE ADDRESS: 1708 WOODGATE LANE LqT: 25 BLOCKe 1 WOODGATE 3RD PeI.No: 10-84602-250-01 DESCRIPTION: SIDING/SOFFIT/FASCTA - f. WW,. ~~u°ald~.n_•g Permit Type MUl_TT. (MISC. ) ,~`ui.1c{ing Work Type REPAIR ,,4'G'e n9us .Code 434 ALT, RESTDENTIAL ~ ~^dF~ 0 pn`Q ^ . ° §G~sts, e ~4};..r~..'~:?~' 7 t~§', . •s~a',, , .^~"ay"t-,' w..,/ ~ P . " ~t~• ,g , . . v ~ }3 5l`~";'"~`3~ `•F>„~ ~ ~E ~s~;a ~ ~°-4 -°..:,^i.r--•. i~ c m,' ~ REMARNCCSI L 1710 (LOT 26) 1712 (LOT 28) 1714 (LOT 27) WOODGATE LN FEE SUMlVIARY: VALUA7ION $8,000 Base Fee $137.25 Sureharge $4.00 Tota1 Fee $141.25 CONTRACTOR' - A p p 1 i c a n t - S7. 'Ic OWNER: EX7ERIOR INNOVATIONS INC 18840814 000931$ WOODGA7E TOWNHOMES A55N 2187 OVERLOOK DR JONNNY CAKE FtIDGE Rp BLQOhIINGTQN MN 55431 EAGAN MN (612) 884-0814 ,,.I Mereby aeknawl;edge that_.I hav~, read tha..s.: a.p,plicati,on and stats 'Chat the informRata.on „is carrect' an°ci agree°~tia compl,y wi,~tha"'a11- ap'plicablse '5tate' af Mn'. ` StaCwtes oand:.City a;'f E,agan 0 r,d in,a nces _ ' . . , _ : R'* . ,+2 r > ; '9 a s. . y,u . _ xr , w . . APPLICANT/PERMITEE SIGNATURE qSSUED Y: StGNATWREk 3L91qG997 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD - 55122 681-d675 New Construction Reauirements RemodeURepair Reeuirements ? 3 registered site surveys ? 2 copies of plan ? 2 copies of plans (inGude beam 8 window aizes; poured fid. design; etc.) ? 2 site surveys (exterior additions & decks) ? 1 energy calculations ? 1 energy calculations Mr heated additions ? 3 copies of tree preservation plan ff lot platted after 7/1/93 required: _ Yes _ No DATE: `~-`1 7 CONSTRUCTION COST: - DESCRIPTION OF WORK: d- STREET ADDRESS: »d4. 17/0 ; i 71Z; l*71 LOT BLOCK SUBD./P.I.D. PROPERTY Name: tl?oc~r,,,--k ~v+J~c~Jra~2. ~S ~ • Phone OWNER L„e, Street Address: J~~ I,.~:..~. l ~ i~,~.~~~•~ AJ ~ City: State: 'l(,V Zip; , r CONTRACTOR Company: Phone Street Address: License City: 5 L'i State: Zip: ARCHITECT/ Company: Phone ENGINEER Name: Registration Street Address: City: State: Zip: Sewer & water licensed plumber (new construction only): . Penalty applies when address change and lot change are requested once permit is issued. I hereby acknowledge that I have read this application and state that the information is corre and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. , Signature of Applicant: ~ , IVD OFFICE USE ONLY 7BY Certificates of Survey Received Yes No 4 Tree Preservation Plan Received Yes No Not Required OFFICE USE ONLY . h . A ,Z,4 BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging o 16 Basement Finish 0 02 SF Dwelling o 07 4-plex ? 12 Multi Repair/Rem. 0 17 Swim Pool 0 03 SF Addition ? 08 8-plex a 13 Garage/Accessory ? 20 Public Facility a 04 SF Porch o 09 12-plex o 14 Fireplace ? 21 Miscellaneous a 05 SF Misc. 0 10 = plex o 15 Deck WORK TYPE a 31 New o 33 Alterations o 36 Move ? 32 Addition o 34 Repair o 37 Demolition GENERAL INFORMATION Const. (Actual) Basement sq. ft. MC/WS System (Allowable) Main level sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinklered Zoning sq. ft. PRV # of Stories sq. ft. Booster Pump Length sq. ft. Census Code. Depth Footprint sq. ft. SAC Code Census Bldg Census Unit APPROVALS Planning Building Engineering Variance Permit Fee ~ 7~ S Valuation: $ Surcharge a.00 Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Road Unit Parlc Ded. Trails Ded. Other Copies Total: % SAC SAC Units OUTSIDE WORK ORDER FROINi : of Chicago Title Insurance Company 60 East 4th Street St. Paul, Minnesota 55101 Telep2ione: (612) 227-7226 TO : iv- DATF' RE: FILE N0. Legal Description: A reas: Please Search the recdrds of: ( ) . Dakota County ~ac~r-~ • ( ) City o Eagan and furnish the ol owing in ormation fn cennection with the above: (NOTE: Furnish only that information indicated by "X") 14ake new abstract covering abcve legal deacription Make.new RPC covering above leqal description ~ Continue abstract covexing above legal description (Abstract enclosed) ( ) Make no searches ° ( ) Delinquent Tax Taxes for the year 19 Total Amount Homestead Base Tax Non-Homestea Not Paid District First Ha Pai Plat Pa'id in Full Parce . ~ ~ The unpaid amount of levied assessments, including any interest due. (Q--fh'e amount or approximate amount of pending assessments for local improvements. NONE PENDING ( ) Water Tax Easements as shown on the recorded plat. Judgments Bankruptcies Federal Tax Liens on the following: Such search discloses the following: 7udomants Bankruptcies Federal Tax Liens (i.4--C'heck for $ -5-00 is enclosed. , Send statement to pay if there is a charge for the above requested infcrmation. NOTE: If more room is :.ceded than provided on form, use reverse of the this form and indicate that reverse is used. ( D SEE FtEVERSE. I heraby state that he above is, to my knowledge, a true and correct - statement. DATE May 4, 1978 BY - AgSESSMENT,CLERK CTI T-111 (6-72) YOL*. I PERMIT c Lho L Gi., CITY OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G Eagan, Minnesota 55122-1897 Permit Number: 026854 (612) 681-4675 Date Issued: 12 / 11 / 9 5 SITE ADDRESS: 1714 WOODGATE LANE LQT: 27 BLOCK: 1 WOODGA7E 3RD P.I.N.s 10--84602-270-01 DESCRIPTION: (BA7HROOM) ermit T,ype SF (MISC. ) Type RLTERATTON 0434 ALT. RESIDENTIAL ~p`$~ 3RS aga•~ a.R'o s~.~,.^i'~~ ~3ES ` " ~ ~ n w .,x,'x "'fr '~+1~~,.;:':~~g , 9 . , :~e~$: e , ``;.n ' ,~•;~a s ff u ~ $ ,c.x, e f:.~z.~~~`.~~~~•n , ~a,~ a.. .~•~a a., ~r a `~.~~~i 1 ~ UP REMARKS: FEE SUMMARY: Base Fee $35.00 5urcharge $.50 Lic. 5earch Fee 5.00 7ota1 F'ee $40.50 CONTRACTOR: - A p p 1 i c a n t - S T. Lz C. OWNER: KROGSTAp CQNST 18820381 2000897 GOQDWIN PETER 4197 LOWER 134TM ST 1714 WOODGATE LN SAVAGE MN 55378 EAGAN MN 55123 (612) 882-8976 (612)686-7127 e- e;. ~ p i ¢ " 8 ~ ~a ~ > & ° ~ ' s t & k ^ $ y e f fi F t ~ ~ e ~i ~ y • 8 , i „ & 9 4 ~ s g u s F ~ t 5 . 7 {~"^'aga s~' $ rYe b~ a'c'k'ri ciw l~e d' e. %tti"a~t~`~«I$> hi a.v:e f r~e;a°d s. aRa n d~ as.ta e;k tti' t.at~h~ ~ ;Y~ ,.9 gs,:.. ~j.y, 9~ a;~,' rrec-t.:;an'ci-ia" scab>- "e.:S ~aate=an=~§dM' :~,=~d g r;'e`e~»to,.~:c:om:p:l~:°tha'1;1.,~ aji~p;.~ 1 t n.~ ye tt , „„.,3.. °5tatu.tes= 4 a:~ z~E a ~ayn ,0~" ,ci= 'a°n'ci n C i~:t.` r .i n a ri~cRe=s; p. y.N ~ 9., ~:•~„e _a-.a. , eq p. . x s a s r, q~. r ~a ' . . r.. ~,e•':. a . , - „ . ..:s. ~ . _ . . - . . . . , , _ L APPLICANT/PERMITE 'SIGNATUR ISSUED B: SIGNATUR~E ~r~ INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: Bu z LoING 3830 Pilot Knob Road Permit Number: 0 2 6 8 b 4 Eagan, Minnesota 55122-1897 Date Issued: 12 / 11 / 9 5 (612) 681-4675 SITE ADDRESS: P• x. N.: 10-84602-270-01 APPLICANT: LOT: 27 BLOCK: 1 1714 WQODGATE LANE KROGSTAD CONST WOQDGATE 3RD (612) 882-8976 PERMIT SUBTYPE: TYPE OF WORK: 5F (MISC.) ALTERATION DESCRIPTION (BATHROOM) INSPECTION . .A FRAMING ROUGH IN PLB6 ROUGH IN HTG FINAL , - lct641995 CITY OF EAGAN 4 0 3830 PILOT KNOB RD - 55122 BUILDING PERMIT APPLICATION (RESIDENTIAL) 681-4675 New Construdion Reauirements RemodeURepair Reauirements ? 3 rogistered aite sunreys ? 2 copies of plan ? 2 copies of plans (indude beam 8 window sizes; poured ind. design; etc.) ? 2 site surveys (exterior additions 8 dedcs) ? 1 energy calculations ? 1 energy calculations for heated addftions ? 3 copies oi tree preservation plan ff lot platted aRer 7/1/93 required: _ Yes _ No DATE: CONSTRUCTION COST: DESCRIPTION OF WORK: 9111JJY~x&0-1- x~- STWET ADDRESS: f`~ Gvvoc~ oA-e- ? LOT ~ BLOCK SUBD./P.I.D. ~ PROPERTY Name: PLO f-lz/ 6000~~ )h Phone 67,56 - 7/2-7 OWNER `^S' ""S' Street Address• 3 3 T el'P . ~ City: State: Zip: 5 5/ a~ CONTRACTOR Company: /t'1-445 ~ ~s~ • Phone Street Address: 7 13y'' License #:-ZpUOs-9 City: State:Zip•5'S72S~ ARCHITECT/ Company: Phone ENGINEER Name: Registration #Street Address* City: State: Zip: Sewer & water licensed plumber: . Penalty applies when address change and lot change are requested once permit is issued. I hereby acknowledge that I have read this application and state that the information is correct and agree to co with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY Certificates of Survey Received Yes No Tree Preservation Plan Received Yes No OFFICE USE ONLY ,~',e,•- v+r BUILDING PERMIT TYPE 0 01 Foundation o 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish ? 02 SF Dwelling o 07 4-plex ? 12 Multi Repair/Rem. ? 17 Swim Pool 0 03 SF Addition ? 08 8-plex o 13 Garage/Accessory o 20 Public Facility a 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscellaneous ~-05 SF Misc. 0 10 = plex o 15 Deck WORK TYPE 0 31 New G-:13 Alterations o 36 Move ? 32 Addition o 34 Repair o 37 Demolition GENERAL INFORMATION Const. (Actual) Basement sq. ft. MC/WS System (Allowable) Main level sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinklered Zoning sq. ft. PRV # of Stcnes sq. ft. Booster Pump L!~-ngth sq. ft. Census Code. ~f3y Depth Footprint sq. ft. SAC Code ~ Census Bldg i Census Unit o APPROVALS Planning Building Engineering Variance ~ Permit Fee Valuation: $ Surcharge Plan Review License MCNVS SAC City SAC Water Conn. ' Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: % SAC SAC Units CITY OF EAGAN CASHIER: JS TERMINAL NO: 729 DATE: 09/05/00 TIME: 10:30:41 ID: 'I NAME: LD PETERSON CONSTRUCTION , 3210 9001 1746-VOODGATE L 60.00 3430 9001 1746 WOODGATE L 0.75 2155 9001 1746 WOODGATE L 0.50 3210 9001 1710 WOODGATE L 60.00 3430 9001 1710 WOODGATE L 0.75 2155 9001 1710 WOODGATE L 0.50 Total Receipt Amount: 122.50 CR136844 USER ID: JAN 2000 BUILDING PERMIT APPLICATION (RESIDENTIAL) • " ' ` ` CITY OF EAGAN 3830 PILOT KNOB RD - 55122 ~ ~ - \ 651-681-4675 c) J New Conatrucflon Reaulrements RemocieiiRepai, Kea remenn ~ I ? 3 reglatered atte wrveys showinq aq. ff, of lot, sq. (t. of house 2 copfes of plan and al( roofed areaa C2096 maximum lot coveraae allowed) 1 set of energy calculations for heafed addi8ons ? 2 coples of plans (show beam & window aizes; poured ind. design; etc.) 1 site survey for extedor addfflons & decks > 1 set of energy calculoflons ? 3 coples ot hee preservaflon plan If lot plaffed after 7/1/93 Oc> DATE: CONSTRUCTION COST: v ~ o ~ DESCRIPTION OF WORK: STREET ADDRESS: r -~/6 wd 0) L LOT: BLOCK: SUBD./P.I.D. Name: Phone PROPERTY laat Flrst • OWNER Shset Address: City State: Zip: . Company: L / "'c T-e v fo r. ~ p L-e Phone "'1'12- `7 c CONTRACTOR (area code) 6 , sq 0 llcense #°1~2 Exp. 3 3~ ) Sheef Address: V City / Ov llhe. 0414111 State: Zip: s~ 3-2 Z , ARCHITECT/ ENGINEER Company: Name: Telephone ( ) Sheet Address: Registraflon City State: Zip: Sewer/water licensed plumber (if Installinsa sewer/waterPhone ( I hereby acknowledge ftat I have read this application, state that the information is coRect, and agree to omply with all appflcoble State of Minnesota Statutes anci City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY Certificates of Survey Received Yes No ' R~',-'~ Ta~,7.' .~r_. ~ ' Tree Preservation Plan Received Yes No Not Required AUG 31 2000 ~ ~Y: OFFICE USE ONLY ~ ' BUILDING PERMIT SUBTYPES . ? 01 Foundation 0 07 05-plex ? 13 16-plex ? 21 Porch (3-sea.) ? 31 Ext. Alt - Mufti ? 02 SF Dwelling 0 08 06-plex ? 17 Garage 0 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF 0 03 01 of _ plex ? 09 07-plex p 18 Deck ? 23 Porch (screened) 0 36 Mufti ? 04 02-plex ? 10 08-plex ? 19 Lower Level 0 24 Storm Damage ? 05 03-plex ? 11 10-plex Plbg _Y or_ N? 25 Miscellaneous ? 06 04-plex O 12 12-plex O 20 Pool 0 30 Accessory Bldg. WORK TYPE l~ 31 New 0 36 Move Bldg. ? 43 Reroof 32 Addition ? 37 Demolish (Bldg)' ? 44 Siding ? 33 Alteration ? 38 Demolish (Interior) ? 45 Fire Repair ? 34 Repair ? 42 Demolish (Foundation) ? 46 Windows/Doors ' Give PCA handout to applicant for demolition permit GENERAL INFORMATION SAC Code ~ # of Stories sq. ft. No. of Units Length sq. ft. No. of Buildings Width Footprint sq. ft. Const. (Actual) S-!!J Basement sq. ft. Census Code 3 ~ (Allowable) ~ Main level sq. ft. MC/ES System UBC Occupancy R-3 sq. ft. City Water Zoning p- iJ sq. ft. Booster Pump PRV Fire Sprinklered MISCELLANEOUS INSPECTIONS ? Stucco/Stone APPROVALS Planning Building 14Z Engineering Variance Permit Fee Valuation: $ Surcharge 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: SAC Units % SAC • , y AS ~ UI 0Q4 O ? ~ WOODGATE HOMEOWNERS ASSOCIATION III P.O. Box 21012 Eagan MN 55121 Tuesday August 29, 2000 TO: ~ City of Eagan ATT: Inspections Department RE: Permit application To Whom It May Concern, The Woodgate III Homeowners Association Board has entered into a contract with Larry Peterson to construct two decks at 1746 Woodgate Lane and 1710 Woodgate Lane, as soon as possible. Sincerely, ; J : j? ~ ~/l9 / Jo 'Eellows: Secretary bodgate III Homeowners Association CITY USE ONLY L ~ BL / RECEIPT 50&3~ SUBD. X°' DATE: / 95 1995 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: ? single family dwellings ? townhomes and condos when permits are required for each unit FIXTURES EACH NO. TOTAL Shower 3.00 x r = Water Closet 3.00 x Bath Tub 3.00 x = Lavatory 3.00 x Kitchen Sink 3.00 x = Laundry Tray 3.00 x = Hot Tub/Spa 3.00 x = Water Heater 3.00 x = Floor Drain 3.00 x = Gas Piping Outlet * minimum - 1 3.00 x = Rough Openings 1.50 x = Water Softener 5.00 x = Private Disposal * Dakota Cty. license 20.00 = U.G. Sprinkler * home under const. 3.00 = ~o Alterations to existin 20.00 Water Turn Around 20.00 STATE SURCHARGE .50 S~ TC3TAL - - - - SITE ADDRESS: OWNER NAME: w~ .AJ INSTALLER NAME: fi ~STREET ADDRESS: CITY: STATE: ZIP: J S~7~ PHONE qy l SMATUREVOFTEWITTE!b~ CITY USE ONLY L BL RECEIPT SUBD. DATE: 1995 PLUIVIBING PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: ? all commercial/industrial buildings. ? multi-family buildings when separate permits are n..2t required for each dwelling unit. D,qTE: CONTRACT PRlrE- WORK TYPE: NEW CONSTRUCTION ADD ON REPAIR DESCRIPTION OF WORK: FEE: $25.00 minimum fee or 1% of contract price, whichever is greater. State surcharge of $.50 per $1,000 of ermi fee due on all permits. CONTRACT PRICE x 1 % STATE SURCHARGE TOTAL SITE ADDRESS: TENANT NAME: STE. # OWNER NAME: INSTALLER: ADDRESS: CITI(: STATE: ZIP: - PHONE SIGNATURE: APPLICANT CITY OF EAGAN 6~. 1991 BUILDING PERMIT APPLICATION / 5 S U~ C~ a~ a 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 - & STRUCTURAL 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 PENALTY APPLIES WHEN: TYPING 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 BE 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. pE e K Fo af-: ivj-5- To Be Used For : Valuation: Date : & Site Address ~71~z GVqod mfF OFFICE USE ONLY Lot 4"1 Block FEES Occupancy Bldg. Permit Zoning Surcharge Parcel/Sub 3~d Actual Const Plan Review , Allowable SAC, City Owner /J/Uda (2141141E.L # of stories SAC, MWCC r Length Water Conn. Address 17154 Gr9,,t/6- Depth Water Meter S.F. Total Acct. Deposit City/Zip Code Footprint S.F. S/w Permit S/W Surcharge Phone On site sewage_ Treatment P1. ~ On site well Road Unit Contractor ~r~jyrJ~si3c. ~afv,"~ MWCC System _ Park Ded. City water _ Trail Ded. Address PRV _ Copies Booster Pwnp City/Zip Code, E .ss FY, ~lZK SUBTOTAL APPROVALS Penalty Phone Z - ~Z7c- Planner Lot Change .11~ Council TOTAL .N I(% Arch./Engr. Bldg. Off. Variance Address City/Zip Code Phone # c agrees that all work shall be done in accordance with (Signature o Contractor) all applicable State of Minnesota Statutes and City of Eagan Ordinances. 2004 RESIDENTIAL PLUMBING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please complete for modifications to existing residential dwellings. Date- 1)_// oq Site Street Address D L - Unit # Property Owner 2>reff f7Ud 5('j n Telephone #(Col'a Contractor ~P PIUWD(~-S Telephone# (01 )16- Q§A0 Address ip~ Q -00G, City State MVA Zip The Applicant is: _ Owner ~ Contractor _Other Alterations to existing dwelling Q~S~ n $ 50.00 _Add fixtures to rooms, excluding water softener and water heater Septic System Abandonment _Water Turnaround (add $121.00 if a 5/8" meter is required) 0 .Y 0Q _Other: \ ( ~ v ~ Water Softener ~ Water Heater $ 15.00 ~ replacement _ additional Lawn Irrigation System RPZ_ new _ repair _rebuild $ 30.00 State Surcharge $ .50 Total $ ~ 5 •5~ 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. &\lbl~ C'L,6~ Applicant's Printed Name Applicant's Signature , City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 1708 Woodgate Lane Lot: 025 Block: 001 Addition: Woodgate 3rd PID:10- 84602 - 250 -01 Use: Description: Sub Type: e - Fumace & Air Conditioner Work Type: New Description: Fumace & Air Conditioner Fee Summary: ME - Permit Fee (Replacements) Surcharge -Fixed Total: Contractor: Apple Lake Heating & Air Conditioning 207 150th Street West Apple Valley MN 55124 (952) 431 -4328 Applicant/Permitee: Signature PERMIT City of Eaan - Applicant - $50.50 Owner: Laura L Tumock Frantes 1708 Woodgate Lane Eagan MN 55122 Permit Type: Permit Number: Date Issued: Permit Category: $50.00 0801.4088 $0.50 9001.2195 Issued By: Signature Mechanical EA090095 07/07/2009 ePermit Comments: Quesetions regarding electrical permit requirements should be directed to Mark Anderson, State Electrical Inspector, (952) 445 -2840 I hereby acknowledge that I have read this application and state that the informa of Minnesota Statutes and City of Eagan Ordinances. on is correct and agree to comply h all applicable State Use BLUE or BLACK Ink r----------------- I For Office Use t l ~ Permit Clity of Dian I Permit Fee: 5• 1 3630 Pilot Knob Road 1 t Eagan MN 55122 Date Received: 1 Phone: (651) 675-5675 I t Fax: (651) 675-5694 i StafF. I I t 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 11 Site Address: Uxin Name: Phone: Resident/ Owner Address / City / Zip: Applicant is: Owner Contractor Type of Work Description of work: S:~U Construction Cost: 2 CI LI 0 (h Multi-Family Building: (Yes 1 No ) Company: ~ Contact: \ 0.)1 Contractor Addressor: Q S C- City: - 0 AA /Q0 State: / Zip: Phone: 0 ~Z U-1 l S License r-N r LA -r l-Lead Certificate -Mis-kcr If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan 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 may be classified as non-public if you provide specific reasons that would permit the City to conclude that the are trade secrets. 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.got)herstateonecall.oro 1 hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued In accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. x x App icant's Printed Name Applic t s igna Page 1 of 3 ~0 11, 0 1-t►a 1~ lq Wood, UM t 3 S t I owRooi Wffi 1 iPi(atKilvb 300 t WI}!G6'12Z i S R~ PbOM pS----------- FAMi RESIDENTIAL gUILMING PERIMT APPEJCATM t3 I # We M aad/ P~ Dana = v A*kWS l cILYizkx - °wnw a€waic' , ips Dam of Q& {flee -lype k r Addmw Ai-r 396-1 whY ( page 3 *f adr fin) s Y CtWnxm vM AREA OWy W. CO"STRUCTM A bawd aa: awM' Pb"? w i the awt im motes, kas the car of Eat tsawd a P a: 'Moo onna u nova ~L carshestaaet~atht} net befom yon it~iend to eb b Locates dander - ~4~l1~~---- , 9~e o +~odxs °t~s cxtlr d I t ooy wftwWkW9e ideR tdl~ Inwa is and toolcatto oara~ for a° ~ "d vx* is ad ft ded y s P In W t tats is wg a p,dL t,ct aay an WA gppm",do,"5* a MAW accordwm vMh #w #Vpwed vM lR*A co$e d.io wl~h rw °°d° a 6xeedwwo .dbya Porp~tiostlell aeooaii t dtWd' &A 4~ -4 APpkopft "mte J'i Ir jI'- ~t.c p49a 1 d3 PERMIT City of Eagan Permit Type:Building Permit Number:EA179260 Date Issued:09/26/2022 Permit Category:ePermit Site Address: 1708 Woodgate Lane Lot:025 Block: 001 Addition: Woodgate 3rd PID:10-84602-01-250 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State 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 - Laura L Tumock Frantes 1708 Woodgate Ln Eagan MN 55122 Renewal Andersen 1920 County Road C West Roseville MN 55113 (651) 264-7052 Applicant/Permitee: Signature Issued By: Signature