1001 Wedgwood Lane N
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- CITY OF EAGAN
. 3795 P{lof Knob Rood Eayon, MN 55122 7837
+ PHONE: 454.8100 ,
BUILDING PERMIT ReceiPt # . ~
Te be wad fee SF LWG/GAR Est. Value Dute 1i.AICh 15 19 83
5ite Address 1001 WedFtwood Lar.e ortii Erect ;a Occupancy F-3
Lot 1 Blxk 5 Sec/Sub. '~ec ~.woc~i 15t Alter ? Zoning R-1
parcel # 10 83550 310 05 Repair ? Fire Zone NA
Enlarye 0 Type of Const. v
lx Name Paul & Jean 7edo Move ? # Stories
Z Address 1355 Iiigh Site I)rivc pemolish p Length 50
~ C; F.afian 55121 p},one 452 -,3317 Grode ? Depth 42 Sq. Ft.
o Na,~,~ Grand Oaks Develonuent Co. Approrals Fees
Address 7623 Upper 167th St. tvest Assessment Permit 316.00
urp Lakeville 5504~0~ 432-6E61 woter & Sew. Surchorge 30.5t~
Palice Plan check 158,00
Pu .0-11 Na?ne Fire 5AC 525.00
~z Address Eng. Woter Conn450.00
<W Ci Phone Planner Water Meter 60,00
Council Road Unif ??n • 00
t hereby ucknowledge that I hove read this applicotion ond stote thar Bldg. Off.
the informotion is correct ond ogree to comply with oll applicable Sl~ay. ~0
Stnte of Minnesofo Statutes and City of Eagon Ordinonces. APC Total
Slqnoture of Pertnittee
GYSnd Oaks uevelopr.ieiit Co.
A Bullding Permlt Is issued to: on the express conditbn thni
all work sholl be done in eccordonce with oll opplicable Stote of Minnesoto Stotutes ond City of Ea9an Ordinoncea.
Buildinp Offitial
Permit No. Permit Holder Misc. Parmit No. Holder
Plumbin9 3a~ iV~~bou~a.~~~s 3-L3-g3
H.v.a.c. 3 SSg niui le~`~ ~-Z7~'3
w.u
wn.~
Disp. •
S"wer
Eleetric Mas4rEI&- 3-77'93 4M i
1110414y'( << <I 1,
Inspection Date Insp. Other
Footinip
Foundation
Freming
Rouyh Plby.
Rouph HVA Inwlation
Finel Pibg - IJ41
Final HVAC -Z ~
Finsl w
r `
Waur Desc?ibe Location:
YWII '
Sswer
Pr, Disp. ' -
~ CITY OF EAGAN
~ 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
~ PHON E: 454-8100
BUILDING PERMIT Receipt #
To bevsed for FXREPLACE Est. Value i.W' Date ,19 1v
Site Address 10~.~'1 S~J~I~~`~?~C''~C) T-'. ` OFFICE USE ONLY
Lot 1 Block 3 Sec/Sub. OnSiteSewage Occupancy
MWCC System Zoning
Parcel No. on Site weu (,actual) Const
ac Name ~~1:3 ~ ~,TAIT('~~ CityWater (Allowable)
z Address 1001 ~FLN.="_'P PRV Required # of Stories
3 Booster Pump Length
0 City WAN PhOne 452- a,i
Depth
~ Name S.F.Total
.O
~ Q Address Footprint S.F.
City Phone pPPROVALS FEES
~ ac Engr./Assess. Permit 4'4 • 00
W Name ~
, Wz Planner Surcharge •
_ - Address
PhOne Council Plan Review
L) = C~ty
4"' 81dg. Oft. _ SAC, City
I hereby acknowledge that I have read this appiication and state lhat the Variance SAC, MWCC
information is correct and agree to comply with all applicable 5tate oi WaterConn.
Minnesota 5tatutes and City of Eagan Ordinances. Water Meter
5ignature of Permittee
Road Unit
A Building Permit is issued to: Treatment P1
on the express condition that all work shall be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances. Parks 24'50
z Building Official TOTAL
Permit No. Permit Holder Date TNephone tt
Plumbing
H.V.A.C.
Electric Softener
Inspection Date Insp. Comments
Footings I
Footings II
Foundation
Framing
Roofing
Rough Pibg.
Rough Htg.
Isul.
Fireplace
Final Htg.
Final Pibg.
Bldg. Final
Cert. Occ.
Temp. LP
Deck Ftg.
Deck Final
Well
Pr. Disp.
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Bax 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT Receipt #
To be used for Est. Value ~ Date 1969
Site Address
Lot I Block 5 Sec!Sub. • i OFFICE USE ONLY
PdrC@I NO. Occupancy - FEES
Zoning
W Name '~ENNz CBM, (Actual) Const _ Bldg. Permit 16,
~
3 Address V%01 ~'~'GD (Allowable) - sq
Surcharge ~
0 ti At::Y. ' ri ! t. ~ ; • # of Storles
City PhOnB Lengih Plan Review
, p Name Depth SAC. City
0Q Address S F. Total - SAC, MCWCC
¢ City Phone S.F. Footprints
On Site Sewage Water Conn
~
W W Name On Site Well Water Meter
Z MWCC S stem
~ Z Address y - Acct. Deposit
a W City Phone City water
PRV Reqwred _ S'W Permit
I hereby acknowlege that I have read this application and state [hat the Boosier Pump S,W Surcharge
information is correct and agree to comply with all applicable 51ate of
Minnesota Statutes and Ciiy of Eagan Ordinances. Treatment PI
Signature of Permitee APPROVALS Road Unit
A Building Permit is issued to: DENNi S $1 `Z-l Planner - Park Ded.
on the express condition that all work shall be done in accordance with all Councii .5U
applicable State of Minnesota Statutes and Ciry of Eagan Ordinances. Bidg. Off. _ Copies
Building Official Variance - TOTAL ~ 3~~~^
Permit No. Permit Molder Date Telephone #
WATER
SEWER
PLUMBING
H.V.A.C.
1-s~C~r,~,/7 ' L • i ~az
ELECTRIC ~V 7'7' ~ C,
Inapsction Date Insp. - Comments
Foolings I
Foundation
Framing
Roofing
Hough Plbg.
Ragh Htg.
Isul.
Fireplece
Final Htg.
Final Plbg.
Const. Meter Plbg. Inspector - Notify Plumber
Engr./Plan
Bldg. Final
Deck Ftg.
Deck Final j 2/ J p! h Q h s-aeef-el
Well
Pr. Disp.
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE: ~ E+= r w~,
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
~ i:(lN41(lM, I ANf N
PERMIT SUBTYPE: TYPE OF WORK:
, t:ijr,! i 1 0 i .i+
INSPECTION . .A
~ . j7 1 1~'. .
I r . . J
Permit No. ParmN Holder Date Telephons K
ELECTRIG 1 gq a°
PLUMBING /D
HVAC
Inspsctlon Date Insp. Comments
FOOTINGS
FOUND
FRAMING fi
ROOFING
PLOUMBING C= ~ /r v/Svp~
PLBG ~
AIR TEST
ROUGH
HEATING
GAS SVC
,EsT D a~7 ~
lNSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIF TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT F.I.
BSMT FINAL m3 O A?CWd
! 2-6-qG /~*8 r 2- S- 4G A45 No .w
DECK FTG
DECK FINAL
Receipt ` MECHANIGAL PERMIT Parmit No.
CITY OF EAGAN ~
- Fee .
Fill in numbered spaces S/C
Type or Print legibly Tot. ~
1. Date 2. Installation Cost .
, -
3. Job Address j00 Lot ~ Blk. S Tract ~
4. awner
5. Contractor ' - Phone r- L
6. Address = - ' _ ' ; - - - f
7. City : State Zip
8. Building Type: Residential ? Commercial O Institutional ?
9. Work Description: New ? Add ? Alter ~ Repair ?
10. Describe Fuel Type
11. No. Equinment BTU - M. Ea. No. Equipment CFM
~ Forced Air ' Air Handling:
Mfg.
Boi lers
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 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
Receipt PLUMBING PERMIT Permit No.
C1TY OF EAGAAI
~ Fee ~
FilJ in numbered spaces S/C -
Type or Prini legib/y Tot.
1. Date 2. Installation Cost
1)c-. - ; ~
3. Job Address Lot i Blk. 7ract
4. Owner
5. Contractor Phone
6. Address
7. City State Zip
8. Building Type: Residential ? Commercial ? Institutional ?
9. Work Description: New ? Add {7 Alter ? Repair ?
10. Describe
11. No, Fixtures No. Fixtures
Water Closet Cesspool/Drainfield
Bath tubs Septic Tank
Lavatory Softner
Shower Well
Kitchen Sink
Urinal(6idet Other
Laundry Tray
Floor Drains
Drinking Ftn.
E 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: Oate Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 464-8100
CITY OF EAGAN Remarks
Addition WEDGUJOOD lst ADDN Lot 1 Blk 5 Parcel 10-53550-010-05
Owner Street 1001 FVedgwood Lane North State EAGAN NIlV 55123
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF. CALI
1 5 .69 2.93 Z
U-T STREET RESTOR.
GRADING 5ql 1981 186.48 12.43 15
Sewer Lateral SZL- 1981 313.16 20.88 15
SAN SEW TRUNK 5 79 1981 198.50 13.23 15
SEWERLATERAL 513 1981 197.54 9.87 20
Sewer Lateral 1982 133.17 8.87 15 _
WATERMAIN
WATEFLATERAL Trk 1981 262.1$ 17.48 15
WATER AREA 1981 198.50 13.23 15
*Water Lateral 1982 98.57 6.57 15
STORM SEW TRK
STORM SEW LAT
*Powerline Relocatio 1982 15
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. ~ 0.00 ti t~
SUILDING PER. 7817
SAC t+ "
PARK
CITY OF EAGAN
. 3830 Pilot Knob Road, P.O. 8ox 21-199, Eagan, MN 55121 N9 15878
` PHON E: 454-8100
BUILDINGPERMIT Receipt# 101 To be used for FIREPLACE Est. Value $1,000 Date NOV 18 ,1988
Site Address 1001 WEDG4700D LN N OFFICE USE ONLY
LOt 1 BloCk 5 Sec/Su6. WEDGWOOD iST OnSiteSewage _ Occupancy
MWCC Syslem _ Zoning
ParCelNo. OnSiteWell _ (Actua1) Const
rc Name DENNIS 8e PATRICIA BYRD Ciry Water _ (Allowable)
W PRV Required # of Stories
~ Address 1001 WEDGWOOD LN N -
a Ciry EAGAN Phone 452-4230 BaosterPUmp - Length
Depth
, o Name SAME S.F.7otal
~ a Address Footprint S.F.
i- City Phone pppROVALS FEES
~a Engr./Assess. Permii 24.00
W Name
Planner Surcharge •$0
Address
Cit PhOne Council PlanReview
qW Y
BIdg.OH. SAC, City
I hereby acknowledge that I have reatl this appliwtion antl staie that the Variance SAC, MWCC
information is correct and a ree to comply wilh all applicable State of Water Conn
Minnesota StaWtes antl Ci t Eagan OrdinanceyP~
Water Meter _
Si9nature of Permittee Road Unit
A Building Permit is issued to: PATRTCTA RVRD_ Treatmenf P1
on the ezpress condition ihat all work shall be done in accordance with all
applicable State ol Minnesota Statules and City of Eagan Ordinances. Parks
TOTAL 24.50
Building Official e,-
. CITY OF EAGAN N~ 16648
" 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
BUILDING PERMIT PHONE: 454-8100 Receipt # G~ S;L 3
To be used for DECK Est. Value $1,000 Date JUNE 15 1989
Site Address 1001 WEDGFTOOD LN N
Lot 1 Block 5 SedSub. ~DGWOOD 15T OFFICE USE ONLY
PflfC21 NO. Occupancy - FEES
Zoning -
W Name DENNIS SYRD (AduapCOnst - BIdg.Permit 26.00
o Address 1001 WEDGWOOD LN N (qlmwable) - Su¢narge .50
City EAGAN Phone $72-$084 aoisiones -
Lenglh _ Plan Review
, o Name SAME Depth - SAG City
ga Address s.F.rotai - snc,MCwcc
~ Ciry Phone S.F. Footprinis -
On Site Sewage - `Nater Conn
~
ww Name On Site Well - Warer Meier
w
i~ AddfOSS MWCCSystem -
o~ Acc1. Deposit
aw Clty PhOn6 CiryWater -
PRV Re9uired - SNd Permit
I here6y acknowlege that I have read this application and siate that the Booster Pump - SNJ Surcharge
inlormation is correct and agree to comply with all applicable State of
Minnesote Statutes and Cily f n Ordin! p es. Treatmenl PI
SignaNre of Pertnilee APPROVALS Road Unit
A Building Permit is issu to: DENNIS B Planner - park Ded.
on ihe express condition that all work shall be done in accordance with all Council .50
applicable State of Minnesota Statutesf and~ yCyi~ry of Eagan Ordinances. BIdg.Off. - ~0P'~
Building Oflicial ~31IA. ~ f~ 1~ Vanance - TOTAL 27.00
cirr oF Ence,N N• ~ 783'7
9790 PiIW Kneb Roed Eagan, MN S5122
~PHONEi 454-6100
BUILDING PERMIT 2eceipt # 3~
To bs wed h. SF DWG/GAR Est. Value $61,000 Dore March 15 1 q 83
Site Addreu 1001 WedAwood Lane North g_3
Erect ~C Occupnncy
Lot 1 Block 5 See/Sub. Wedgwood lst qlter ? Zonlnq R-1
parcel # 10 83550 010 OS Repoir ? Fire Zone NA
Enlarga ? Type of Const. V
W Name Paul & Jean Dedo Move Stories
z Addreu 1355 High Site Drive oemolish ? Length 50
q EaQan 55121 pF1O1e 452-8317 Grade ? Depth 42 Sq. Ft.-
o Nome Grand Oaks Development Co. Avvro.ob Fees
o~ Address 7623 Upper 167th St. WeSt Asseument Permit 316.
" 30.50
Cit LakeVllle 5504~ne 432-6561 Woter 8 Sew. Surchorye
Police Plan check 158.00
Gw Name Fire SAC 525.00
w
Addmaa Enp. Woter Conn,~+$0.00
<W Ci Phone Plonner Water Meter 60.00
Council Rood Unit 250.00
I hereby ackrwwledge fhot 1 hove read Ihis applicofion ond stare fhal Bldg. Off.
Ihe information is correct and ngree to wmply with all aOPlicable $1789.50
State of Minnewto Statutes and City of Eogan Ordirwnces. APC Totol
Slpnuture of Permittee A Bullding Permir is issued ro: Grand Oaks Developme t Co. on the expreu cOndiflon thnt
all work shall be dorre in acwrdance with olt oppli ~lepSy ~ta~te Mi Statutes and Ciy of Eogon Ordinancea.
Bullding Officiol
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
V~O 3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New Conetruction ReauiremeMS RemodellRaoair Reauiremenu
• 3 registered site survays showing sq. R of lol, sq. ft. of house: and II mofed areas . 2 copies af plan
(20% maz'vnum IW wverage allowed) • 1 set af Energy Cakulalions for heated addNons
. 2 copies of plan shawing beam & window s¢es; poured (ouM desgn, etc.) • 1 site survey for ezlerior additians & decks
• 1 sel of Energy Calculations • indiwte if hame served by septic system for additions
• 3 copies af Tree Preservatbn Plan if lot platted after 111193
• Rim Joist DeWtl Options selection sheel (bldgs with 3 or less uni4s)
DATE l0 S- D Z.. VALUATION S~• `s'°~
SITE ADDRESS /00/ WE D4 ,r WbO D Jyl MULTI-FAMILY BLDG _ Y _ N
TYPE OF WORK ;a-f7o0 r FIREPLACE(5) _ 0_ 1_ 2
APPLICANT 41Cal/r- 4o9i.vc /Jtid C500rN4
STREET ADDRESS LSBSEDNNd.//r' 81v0 S~.rc /3e CITY EDfN ~d++ki c STATE MAI ZIP 4S3Y
TELEPHONE # 562-4yy-61,13 f CELL PHONE # FAX # Sso?•~ y~i'-~s 8X
PROPERTYOWNER ~5"! JB /Y R>> iELEPHONE# LoS/• 5'.f'a- 2,73 n
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ y(INNESOTA RUI1:S 7670 CATEGOI2Y I _ MINNPSO"fA R[iI.1;5 7672
(J submission type) • Residenlial Ventilation Category 1 Worksheet Submitted • New Energy Coda Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contraetor: Phone #
Plumbing systcm includes: _ Water SoFtener _ Lawn Sprinkler P'ee: $90.00
Water Heater _ No. of R.I. Baths
No. of Baths
Mechanical Coniractor: Phone #
Mcchanical system includcs: _ Air Conditioning Fcc: $70•00
Hcat Recovery System ~n
Sewer/Water Contractor. Phone # ~ ~
JUN 2 0 2002
- - - - -
v-- -
I hereby acknowledge that I have read ihis application, state that the information is corre and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordinances. ~g„ _ -
Signature of AppOcanf
~ OFFICF. USF, ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4/02
Prepared for _Grand Oaks Develo ment Corp. Sheet No. 1 _
~ RESIDENTIAL Address Date 2-1-83
HEAT GAIN & LOSS B~ 0 del JobNo.
J& B Sheet Metal Inc. Aio 1.5.1
RAPID ESTIAAATE estimator REV 2
Salesman Bin2 _ DATE 7115/77
DESIGN CONDRIONS INSUTATION HOUSE FACES OVERHqN G OR SHpOING
COOLING DB °F NEATING D8 °F CaiBng ~8 Norih ~l"
Outside Temp 95 Inside Temp 68 wali lA i East
Inside Temp Outside Temp Fbor ? South
Temp Diff -2~ Temp Ditf 8 Window ? West
TYPE COOLING HEATING
LOAD AREA
FACING Factor Sens Btuh Pactor Btuh/°FTD
1 GROSS WALL AREA
2 WINDOWS & N- NE 12 22 26 .83 9.9
3 GLASS DOOFS E- SE 100 49 4900 .83 83.0
4(Tables I and II) s- sw 40 24 576 .83 33.2
5 W- NW 121 9 929 .8 175.9
6
7
8
9
70 DOORS E 21. 38 798 2.4 50.4
11 (Tables II and II!)
12
13 NET WALLS N 534 1.7 908 .05 26.7
14 (Table III) F. 212 1.7 360 •05 1.0.5
15 s 506 1.7 860 .05 25.3
is w 191 1.7 2 .0 6
17 CEILING OR ROOF 1008 1.1 1109 .025 25•2
18 (Table IV)
19
20 FLOOR . 132 - - •9 125.4
21 (Table V)
22
23 PEOPLE (NO.) 2 300 600
24 COOKING 1200
A Total Sensible Heat Load (Add all Btuh) 17829 575•2
B Duct Heat Gain (See Table No. VI.) 891
C Grand Total Sensible Heat Gain (Line A+ 8) 18720
D Grand Total Heat Gain (Line C x 1.3) 24336
E Adjusted GTHG (Line D x Swing Factor) 20199
F Total Heat Loss (Line A x Design Temp Difference) 88 50617
G Duct Heat Loss (See Tabie VI.) 20 10123
H Grand Total Heat Loss (Lines F+ G) 60740
SURVEYOR'S, CERTIFICATE SIENNA CORPORATION
, , .
a WlLDERNESS ~ RUN RD.
N R = 64a94
ll=7°35112" 85.27 ~ ~18142,~ I
~ o o \ 30.
/ ~
- DRAINAGE AND UTILITY,,~ 10 O W
C\j I EASEMENT PER PLAT
/LoT I
o
o .
o
o
cv
~ /26.0 ~ 29.
.49.) 0/ M ~
al j CARAGf
~ r 24L0~ do O .
N 1
`J i I f~ T-~3~~~p 41
4.i I
2.0,0 30
zi
3p ~
1 qL ~tt °°~g
~ ~ o M4N~ I ~
/Q
S770,301
wEDGwOpp ~O,E 100.7/ - N~ /
E ° .
REVISED 2-15-83 TO SHOW
PROPOSED HOUSE LOCATION.
FOR GRAND OAKS DEVELOPMENT C0. ~~2•oi ~
QPENOTES IRON MONOMENT SET SCALE: 1 INCH = 40 FEET
• DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FI,OOR 926.0_ FEET
O DENOTES WOOD STAKE PROPOSED LOWEST FIAOR = 923_4FEET
XO00.0 DENOTES EXISTZNG ELEVATION PROPOSED TOP OF BLO.CIC".... = 926.3 FEET
(000.0)DENOTES PROPOSED ELEVATION .
.4~ DENOTES DIRECTION O£ SURFACE DRAIt7AGE '
I hereby certify that this is a true and correct representa£ion of a survey of the
boundaries of:
Lot I, Block 5, - WEDGWOOD FIRST ADDITION, according to.the recorded
plat thereof, Dakota County, Minnesota.
And of the location of all buildings, if any, fhereon, and all visible encroachments,
if any, from or on said land. As surveyed by me this I2}'^day of l~xu 198-z~
pppROVED FOR SIENNA SIGNED: JAMES R. HILL, INC.
CORPORATION
~
BY: O-
ROBERTS ARCHITEGTS BY:
DATED THIS DAY OF Harold C. Peterson, Land Surveyor
198 Minn. License.NO. 12294
PROJECT NO. BOOK / PAGE JAMES R. HILL, INC.
81178
83149 planners / Engineers / Surveyors
FILE NO. 8200 Humboldt Avenue South
~ eoi.usR Bbotnington, Mn. 65431 812-984-3Q29
CqAA WA)M K41 CITY 01' FlC'~T,N Include 2 sets of plans,
1 site plan w/elevations &
BUIL,D7^!G PIiFiN1iT nPPLICATION 1 set ef enerqy calculations.
ViY
VU C'. ~ ~G0.-'~ ~ / / ~j
~b Be Used For ~I~~ Valtoti.on Date
'"~r/
Site Pddress 1001 w~ctGQ.Werc~l OITICT USE ONLY
Ivt ~ Bloc)c ~j Sec./Sub. -"Q~/r~t x Oc:cwancy 3
Parcel (O g35S O 616 C) ~ Altcr Zoninc1 --_^--~j~T-
- Repair Fire 7,oi:e TW-
O.mer: cE do F..nlarc-ie 'Npe of Const.
Adclres s: Slke_ py MOve # Stories
~2jS`~
-
~ Damnlish I'zont it.
City/Zip Ca]e: Yy1 n 5 SGrade Depth y„2 --f-t.
Phone yS%
AP['ICWATS L•'LT.S
Contractnr: ~t#-95 ASSessiant, Pernut -3~~
T9<zter/;ewer Surchargc 30~_
pddress: Z3 ~~TY f(n7 ~'$1-(.()• Pc)licc Plan Check 1S~ ~
City/Zip Code: ke?ti II'. lYIV1 T•'ire ~ SAC
i. Water Conn.
Phone L' Elx ~o sl~O f Ylanner. Water Meter
Irch./En9•: DtCl- I,Uke-49.y~- Counci.l Road [7nit o26't~ ~
- F31dg. Off.
Pddress: N)C
City/7,ip Code:
Phone # : '=AL -7
Sy,9i~
i
I
CITY OF•EAGAN PFRMIT
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55122-1897 Permit Number: 0 2 9 0 5 9
(612) 681-4675 Date Issued: 10 / 16 J 9 6
SITE ADDRESS:
1001 WEDGW000 LANE N
LOT: 1 BLOCK: 5
WEDGWOOD 1ST
P.Z.N.: 10-83550-010-05
DESCRIPTION:
B[iilding"-Permit Type BASEMENT FINISH
Building 4brk Type ALTERATION
Census Code 434 ALT. RESIDENTIAL
! a.
°t
x ~
^°1& .
,it rt t 3 q ,
REMARKS: ,
FEE SUMMARY:
Base Fee $50.00
Surcharge $.50
Total Fee $50.50
.
CONTRACTOR: - Applicant - S7. LIC OWNER:
PAUL LEMKE CONSTRUCTION 16865186 0003550 BYRD DENNIS
1924 COVENTRY CT 1001 WEOGWOOD LN N
MENDOTA HEIGHTS MN 55118 EAfiAN MN 55123
(612) 686-5186 (612)452-4230
S hereby acknowledge that I have read this application and state that the
information is correct and agree to cnmply with a12 applicahle 5tate of Mn,
Statutes and City ofi Eagan Ordinances.
L _ . . : _ . . -
AT/PERM'ITAPPLICE SIGNATURE rISSUED B: SI NATU E
~ CITY OF EAGAN
?
lqosd 3830 PILOT KNOB RD - 55122 ~j r~.?
1996 BUILDING PERMIT APPLICATION (RESIDENTIAI.)
681-4673
New Construction Reauiremants RemodeUFieoair Reouirements
? 3 registered sile surveys ? 2 copies of plan
? 2 copies ot plans (includa beam 8 window sizes; poured fnd. design; etc.) ? 2 site surveys (exterior additions 8 decks)
? 1 energy calculations ? 7 anergy calculations for heated additions
? 3 coDies of tree preservation plan if lot platted afler 7/7/93
required: _ Yes _ No
CONSTRUCTION COST:(~~T
DATE:
DESCRIPTION OF WORK: '~f~~~?~"~ d ~~tPi-B~' ~~7/f~9~iX
STREET ADDRESS:
LOT BLOCK ~ SUBD./P.I.D.
PROPERTY Name: ~ 412 Phone
OWNER ' uc• rins*
Street Address:-&j /V -
City: State: 1-7_ Zip: uS~ ~
CoN7w?croR CompanyAU/ Phone
Street Address: VC111'X ~fGvlff- License 3
City: I;Izl--3 State:Zi • 32/
ARCHITECTI Company: Phone
ENGINEER
Name: Registration
Street Address•
City: State: Zip:
Sewer 8 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 comply with all
applicable State of Minnesota Statutes and City of Eagan Ordinances. ~
Signature of Applicant
OFFICE USE ONIY
Certificates of Survey Received _ Yes No OCT 1 1 1996
Tree Preservation Plan Received _ Yes _ No
OFFICE USE ONLY
s + e{
¢ r^
BUILDING PERMIT TYPE
0 01 Foundation ? 06 Duplex ? 11 Apt./Lodging e,16 Basement Finish
? 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. ? 17 Swim Pool
? 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility
? 04 SF Porch ? 09 12-piex ? 14 Fireplace ? 21 Miscelianeous
? 05 SF Misc. ? 10 = plex ? 15 Deck
WORK TYPE
? 31 New .,~3 3 Alterations ? 36 Move
? 32 Addition ? 34 Repair ? 37 Demolition
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MClWS System ~
(Allowable) Main level sq. ft. City Water I
UBC Occupancy sq. ft. Fire Sprinklered
Zoning sq, ft. PRV
# of Stories sq. ft. Booster Pump
Length sq. ft. Census Code. -434
Depth Footprint sq. ft. SAC Code _~^+L
Census Bldg i
Census Unit U
APPROVALS
Planning Building i1h13 Engineering Variance
Permit Fee Valuation, $
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Pertnit
S/W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
% SAC
SAG Units
1989 B(JILDIAG PERMIT APPLICATION
CITY OF EAGAN 15~
Ic,44 1 ~
SINGLE FAMILY DWELLIAGS lIDLTIPLE DHELLIN(35 C0MMERCIAL ~
2 3EfS OF PL9NS 2 3ST3 OF PL?NS 2 3ETS OF ARCHIIECTURAI. ~
3REGISTERED SITE 3DRYEYS BEGISTfiRED 3ITE SOAQEY3 - 3 STBOCTDAAL PLANS
1 5ET OF EAEAGY C9LCS. (CHECH BITH HLDG DIV.) 1 3ET OF SPECIFIC9TIONS
1 3EP OF EBSRGY GLC3. 1 SET OF ENEBGY C9LCS.
!lULTIPLfi D1iELLINGS HENfAL U9IT3 F09 SALS Uffm • OF OHITS
BOTEr IDDAES3E4 FOx CORNER LOTS - COATAACTOR/HOMEOWNER M03T DF.SIGNATE iiSICH ADDRFSS
IS DFSIRED. HO CHANGFS iIILL BE iLLOiIED ONCE BOILDING PERHIT I3 I3SOED..
SENER 6 AATER PERMIT FEES AND lCCOUNT DEPQSIT F6fiS iTII.L Bfi IIVCLDDED UITH THE HOILDINfi
PE[UlIT FEE. PROCESSING TIME FOA SE{iER AND AATEA PERMIT3 IS Ti10 DAYS OACE l PERMIT HlS
BEEN COMPLETED INDICITIAG A LICEN3ED PLOlBER.
PENALTY APPLIES IdHENs PERMIT IS P10T PAID FOR IN SAME MONTH IT IS REQUESTED.
LOT CHAtdGE IS AEQOESTED ONCE PERMIT I3 ISSQED.
ffE'QJUN 12~
To Be Used For: Valuatioeonl~-Date:
Site Address tDDI ~e,~~e,wood Ln.N. OFFICE 05S Ol9LY
Lot _J_ Bloek L Occupaney FEFS
f~ J~ vQ(~ Zoning
Parcel/Sub , ~t/u-GZ~ J--' Actual Const Bldg. Permit ~-G
Allowable Sureharge .170
Oimer D e n v, ) s I of stories Plan Reviea
I Length SAC, City
Address 10 O! WP, kzP. W o e) d ~ N/U 1)epth SAC, MWCC
~ S.F. Total Nater Conn
City/Zip Code E, LLR a N ~.ri 1~,13 Footprint S.F. Aater Meter
K w Aect. Deposit
Phone ~0 3 t7 fi7 aOn site aewage S/W Permit
On site well 3/W Sureharge
Contraetor MWCC System _ Treatment Y1.
City water _ Aoad Unit
Address PRV required _ Park Ded.
Booster Pump _ Copies .so
City/Zip Code sUBTOTAL
APP80PALS Penalty
Phone Planner _ TOTAL 7. b
Council
Arch./Engr. Bldg. Off. 6~14
Yariance
Address
City/Zip Code
Phone g
:,Ri%EYOR'S' CERTIFICATE -SIENNA CORPORATION ~
d
~ q
3-
a W/LDERNESS g RUN RD. T~
N R=64a94 ~ _70
a=7°35'12" 85.27, -,~1LZ1 I , L/' ~
s ~ ao
! , ~ O
DRAINAGE ANO UTILITY,%~ 10 O ~ ~ d
- ` M I EASEMEN7 PER PLAT i ~ ~:k, ~
~ LOT I I cr ~ ?
_w ll .
'O New Dccks I O
O
o
- C\j ~ .o, ~ O O
c'~ 2 0// ?'r) 3 -
ol j eARAOE /BW 1 , e O ~
zB~/ 4~ ~ I ~ ~ •
II
~v 3
- SIY7.9= _ e~i '~i I
2'.0 ~ 30
20,
_ ~ _ . 0~ oRN~N~
~/p Q'
~ ? S 7T030.' o~/
WZDaWOpp Qyt /00.71 ~ N
~
to=a„ ~ ti L.Q /~/,E
REVISED 2-15-83 TO SHOW ~ h.
PROPOSED HOUSE LOCA7ION.
FOR GRAND OAKS DEVELOPMENT C0. ~9~•oi
O DENOTES IRON MONUMENT SET SCALE: 1 INCH = 40 FEET
• DENOTES ZRON MONUMENT FOUND PROPOSED GARAGE FIAOR 826.0 FEET
0 DENOTES WOOD STAKE ' PROPOSED LAWEST FIAOR =,_223_4 FEET
X000.0 DENOTES EXISTING ELEVATION PROPOSED TOP OF BLOC&"-.., = 926.3 FEET
(000.0)DENOTES PROPOSED ELEVATION ,
.4- DENOTES DZRECTION OF SURFACE DRAINAGE I hereby certify that this is a true and corzect representation of a survey of the
i,
boundaries of: +
Lot 1, Block 5, ' WEDGWOOD FIRST ADDITION, according to,the recorded
plat thereof, Dakota County, Minnesota.
And of the location of all buildings, if any, thereon, and all visible encroachments,
iE Inv.1 fswm or on_ said_ land., As suiveyed bv me this Ll'"day of
- . _ - ~
1988 BUILDING PERMIT APPLICATION - CITY OF EAGAN
SINGLE FAMILY DWELLING3 /ET INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURENERGY CALCULATIONS
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACMQST DESIGN9TE WFIICH ADDRESS
IS DESIRED. NO CHANGES WILL HE ALLOWED PERMIT IS ISSUED.
M[TLTIPLE DWELLINGS RENT9L ONITS FOR SALE UNITS # OF IINITS
INCLUDE 2 SETS OF PLANS, CEATIFICATE SURVEY - CHECK WITti BLDG. DEPT.,
t SET OF ENERGY CALCULATIONS
COMMERCIAL
INCLUDE 2 SETS OF CHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPEC ATIONS AND 1 SET OF ENERGY CALCIILATIONS
r ( ,l~f~0 00 o
To Be Used For: ~"IAEPLtN CE Valuation: Date:
Site Address 1 DOI LJEDa WO-61~p LN IV OFFICE USE ONLY
Lot ~ Block ~I On site sewage_ Occupaney
y MWCC system Zoning
Parcel/Sub On site well _ Aetual Const
City water Allowable
Owner --D E iJn1 ~ S~PPr 7 RiC 1 A f~'~(Z i> PRV required _ ll of stories
- f Booster Pump _ Length
Address jnn j i,~)E ;>G C,JOO'~ L ti ~V Depth
S.F. Total
City/Zip Code F f:~ Footprint S.F.
Phone ~ !j .2 H a APPROVALS FEES
U'7
Contractor Engr/Assess Permit
Planner Surcharge So
Address Council Plan Review
Bldg. OFf. SAC, City
City/Zip Code Variance SAC, MWCC
Water Conn
Phone Water Meter
Road Unit
Areh./Engr. Treatment P1
Parks
Address Copies
j TOTAL ~
City/Zip Code !
Phone lf
1999 BUILDINC PERMIT APPLICATION (RESIDENTIAL)
. CITY OF EACAN
~ E830 PILOT KNOB RD - 55122 r1" ~ r 0(~
851-681•4675 c1D
New ConshucNon Reaulreme~s ~ RemodeVReoah Reauirements
D 3 eegMered sMe suneys showing sq. ff. W lof, sq. lt. of house 2 coples of plan
and 21 rooled areas (20% mmcimum bf eoveraae allowed) 1 sM of energy calculalions for heoTed addlNons
D 4 copies of plans (show beam E window sIxes; poured Ind. design; etc.) 1 sRe suney lor exferbr addfNons 6 decks
D 1 sef of energy caleulaNons
D 3 copies of hee preservaHon plan tl lol plaMed Wler 7/1/93 ~
DATE: CONSTRUCTION COST:
DESCRIPTION OF WORK: ~P (a-GI O`"."4 f'/-r d~~_
STREET ADDRESS: 16701 L/~ /Ndu v( G/v lv~
LOT: BLOCK: ~ SUBD./P.I.D.#: ~
Name: Phone
PROPERTY ~ Lcmt Fkd
OWNER StreetAddress: /001 vv~°~`,~~w"v` `/v ~v
City 15-6- L 0-~ State: /"W Zip: 5TX~3
Company: Phoae
(area code)
CONTRACTOR
Sheet Address: Ucense # Exp.
CNy State: Zip:
ARCHITECT/
ENGINEER Company: Name:
Telephone area code ( )
Sheet Address: ReglstraHon
CMy State: Zlp:
Sewer d, water Itcensed plumber freaulred for new conshucflon onN
Penalfy applles when address change and lot change Is requested once permH Is Issued.
I hereby acknowledge thal I have read this applicaNon, sfaFe fhaf ihe IMormaFion is correcf, apd agree fo comply with all applicabl
Stafe of Mlnnesota StaMes and CHy of Eagan Ordinances.
Slgnature of ApplicaM:
OFFICE USE ONLY Lil('
Certificates of Survey Received _ Yes _ No ~ I L-
Free Preservation Plan Received _ Yes _ No _ Not Required
OFFICE USE ONLY _
BUILDING PERMIT TYPE
? 01 Foundation ? 06 4-plex ? 11 10-plex ? 76 Fireplace ? 21 Porch (3-sea.)
? 02 SF Dweiling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4sea.
? 03 1 of _ plex ? 08 &plex O 13 16-plex ~ 18 Deck ? 23 Porch (screened)
? 04 2-plex ? 09 7-plex O 14 Apartments ? 19 Lower Level ? 24 Storm Damage
? OS 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool O 25 Miscellaneous
WORK TYPE
~ 31 New ? 35 Tenant Impr ? 39 Gas Line Only ? 43 Siding/Soffits/Fascia
O 32 Addition ? 36 Move Bidg. ? 40 Gas Insert ? 44 Windows/Doors
? 33 Alteration ? 37 Demolish Bldg.' ? 41 Wood Stove ? 45 Fire Repair
? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof
* Give PCA handout to applicant for demolRion permit
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. Census Code
(Allowable) Main Ievel sq. ft. SAC Code
UBC Occupancy /7 sq. ft. 42 a No. of Units
Zoning sq. ft. No. of Bldgs
# of Stories sq. ft. MC/ES System
Length sq. ft. City Water
Width Footprint sq. ft. Booster Pump
PRV
Fire Sprinklered
APPROVALS
Planning Buiiding Engineering Variance
Permit Fee Valuation: $
Surcharge
Plan Review X( /2 /
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
SNV Permit
5/W Surcharge
Treatment PI.
Park Ded.
Trails Ded. ~
Other
Copies ,
Total:
SAC Units
% SAC .
t
~ .VEYOR'S CERTIFICATE SIENNA CORPORATION ?
~
• ,
~
a WlLDERNESS g RUN RD.
R=64394
~*ftao, - a=7°35'12" 85.27, licr) 1 ao DRAINAGE AND U7ILITYt...l 1O W ~
EASEMENT PER PLAT a
- ~ LOT I I~~ I
41 o .
r
.o. no4. 0 O
. N, -1~ps.o z+ -
/:4,.r rh 3
rr j ~~RAOE ,sg ~ - .
4O o W 4
loe
J ~ c 3
:,.o ' ap
a044 /
~ ~ n L _ ` . .Ft= ZO'pyEpRM~M~ l , / ~
~ . .
i0 ~ -C~_
0 ~aa-0,
o S 77030t o ~ h
m w pD ~aE /00.71 - Nco /
,•a4„ ° - q YyE. M
REVISED 2-15-83 TO SHOW
PROPOSED HOUSE LOCATION. `
FOR GRAND OAKS DEVELOPMENT C0. f
pIDENOTES IRON MONUMENT SET SCALE: 1 INCH = 40 FEET
• DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLAOR = 826.0 £EET
13 DENOTES WOOD STAKE PROPOSED LOWEST FI.OOR = 923_4 FEET
X000.0 DENOTES EXISTING ELEVATZON PROPOSED TOP OF HLOCK... = 926.3 FEET
(000.0)DENOTES PROPOSED ELEVATION .
-4~ DENOTES DIRECTION OF SURFACE DRA2T7AGE I hereby certify that Ghis is a true and correct representation of a survey of the
houndaries of: ^
Lot 1, Block 5, ' WEDGF100D FIRST ADDITION, according to the recorded
plat thereof, Dakota County, Minnesota_ .
And of the location of all buildings, if any, thereon, and all visible encroachments,
said land. As surveved bv me this l i?Lday of i' x u 198L. J
Q~ -3SS~
L / BL ~ CITY U5E ONLY RECEIPT
-L••-
U o1~ ~ ~
SUBD. " ~ DATE•
1996 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? singie family dwellings
? townhomes and condos when permits are required for each unit
` Rotate furnar.e; patch old return air opening and re-in9ta11 retuin air drop to iurnace Make
' and install new plenum pan and accesa door, also ner_ESSary cransitions fcr rewrn air and
::,;'~supply air. Ramove old line oet; inotall new line set; remove old vEntiny both for iurnace
< aad hot ~~ater :Ieatar ai~d in3tali neH venting. Evacuatie air conclitiuning system, re-route
^ return air to lower bedroom.
Change gas from low to High pressure system and hook-up furnace and hot water heater.
- - - - - -
Date: 10 FFFC
~ Minimum Fee: Add-on/Remodel (existing residence only) $20.00
? HVAC: 0-100 M BTU 24.00
Additional 50 M BTU 6.00
? Gas Outlets (minimum of 1 required @$3.00 each)
? State Surcharge .50
TOTAL
SITE ADDRESS• I00 ~ ~1~.E1V~4lCOc~D L~J N.
OWNER NAME: LC-rti\Ke&1JS-(Pwc-(-1 ON PHONE 457-LI-71
INSTALLER NAME• Ap~~~ ~~-(:Y_
STREET ADDRESS: ~OS~ U N• N(~`r 3~~j LV D.
CITY: nA(=~Au_ STATE:~ ZIP:
PHONE (b(Z) -70 `b(E03
ti-
CITY U5E ONLY
^ • . L BL ~ RECEIPT ~a
SUBD, w~ P-4V DATE: O~a QCv
1996 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please comp4ete for: ? single fami{y dweflings
? townhomes and condos when permits are required for eaCh unit
FIXTURES EACH NQ, TOTAL
Shower 3.00 x = 3
Water Closet 3.00 x
Bath Tub 3.00 ;c =
Lavatory 3.00 x I = *3_
Kitchen 5ink 3.00 :c =
Laundry Tray 3.00 :c 3
Hot Tub/Spa 3.00 :c =
Water Heater 3.00 ! _ 3
Floor Drain 3.00 ;c =
Gas Piping Outlet ' minimum - t 3.00 x =
Rough Openings 1.50 ;c =
Water Softener 5.00 x =
Private Disposal " Dakota Cty. license 65.00 =
(new and refurbished systems)
U.G. S¢rinklei * home under const. 3.06 =
Alterations ` to existing 20.00 = ~e
Water Turn Around 20.00
STATE SURCHARGE .50
TOTAL ~Sv
SITE ADDRESS: 1oa1 W,5b6;F- t0P~b l,N
OWNER NAME: ~•R n
INSTALLER NAME: 1W M~uA~~~-L ~~e~~ / `
STREET ADDRESS:
CITY: STATE: ~A)_ ZIP: -ri5 ~fG6
PHONE
3TGAA'FUKEOFFEFt1Qf 17
cVTY OP PAGAN ATER SERVICE PERMIT
37 -Knob Rood PERMIT '- r. 1 ` '
Eagan, NN 55122 DATE: r r a
Zahitgt x' No. of Units: 1
Owner: C nne, Oats Pev
Address:
Site Address: 1001 S pro od Ti No Li B5 We dgleood I
Plumber: "erona i P 1=1' in F.
Meter No.: Connection Charge: 450.00 pd
Size: Account Deposit:
Reader No.: Permit Fee: 10.00 per
1 agree to comply with the City of Eagan Surcharge: • 50 p
Ordinances. Misc. Charges: 60.00 pd meter
Total:
By 3 Date Paid:
Date of Insp.• V Insp.:
CITY OF E4GAN SEWER SERVICE PERMIT
5795 jlet Knob Rood
&gen, MN 55122
Zoning;:- RT DATE: 3/23/83
Winer: Grand No. of Units: 1
ak s Bev
Mdr ;
Site Address: 1001 We' Ln No Li R5'
Plumber: ? dI Q
.nald P .,h W` = ''noG' 1
1 agree to Pir wit /15/$4 '5 1 1 0.00 pd
Ordinnnees�Y gan Connection • 0 d
'� ccount
'posit:
Pni ee: 1 rultt nd
Y �
.Dote of / Misc. Charges: —�^
r
Total:
^ Insp.:
Dote Paid:
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA126382
Date Issued:08/22/2014
Permit Category:ePermit
Site Address: 1001 Wedgwood Lane N
Lot:001 Block: 005 Addition: Wedgewood 1st
PID:10-83550-05-010
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required by law in ALL single family homes .
Jeff Pelant
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Nicole M Montour
1001 Wedgwood Lane N
Eagan MN 55123
(952) 217-3132
Legacy Restoration Llc
14000 25th Ave N
Suite 110
Plymouth MN 55447
(763) 354-7660
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA144877
Date Issued:08/14/2017
Permit Category:ePermit
Site Address: 1001 Wedgwood Lane N
Lot:001 Block: 005 Addition: Wedgewood 1st
PID:10-83550-05-010
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Nicole M Montour
1001 Wedgwood Lane N
Eagan MN 55123
Haley Comfort Systems
4320 Hwy 52 N
West Frontage Rd
Rochester MN 55901
(507) 281-0138
Applicant/Permitee: Signature Issued By: Signature