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3586 Lemieux CirCity of Eaaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 RECEIVED NOV302010 Use BLUE or BLACK Ink Permit #: C) daleS- Permit Fee: 470 DateReceii: Staff: 2010 RESIDENTIAL BUILDING PERMIT APPLICATION Date: klov, 2010 Site Address: 3511to LQ_rr e t33( Ci t"GlP Tenant: Suite #: RESIDENT / OWNER Name: Ann Ciar k Coryf,troci-Vo Phone: C2M „ _9_51,2:9_43_:_3' Address / City / Zip: 7500 W e --,-i 79th Si-, gd► Oa, ).41L) ;6-439 1 Applicant is: Owner X Contractor TYPE OF WORK Description of work: .. - f — - v - ' i - - 1, ` , i, V.s k+ _tA Construction Cost:01e, .O© Multi -Family Building: (Yes a( / No ) CONTRACTOR Name: Pypn C lC% FC Con °A-. License #: Address: 7500 We- k 7Si }1 Si- City: E.& e)o%. State: M Iv Zip: 55939 Phone: 952 - 9'47 ` 30i 6 Contact: SCS-. ROW Email: Scat' Ce.,I CIc . C.bm COMPLETE In the last 12 months, has If yes, THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING the City of Eagan issued a permit for a similar plan based on a master plan? date and address of master plan: _Yes _No Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: TE: ns at you sub rtar-to . informs [assifie� is u r a { �{ to CALL BEFORE YOU DIG. Call Gopher State One CaII 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.gooherstateonecall.orq 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 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. x ScrTh-ft- 1 oft Applicant's Printed Name Page 1 of 2 Le, ---01/6--(A4 C DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation Single Family Multi 01 of _ Plex Accessory Building WORK TYPES New Addition Iteration Replace Retaining Wall DESCRIPTION Valuation Plan Review (25%_ 100% Census Code # of Units # of Buildings Type of Construction Y Fireplace Garage Deck Lower Level _ Porch (3 -Season) _ Porch (4 -Season) Porch (Screen/Gazebo/Pergola) _ Interior Improvement Move Building Fire Repair Repair REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile Roof: Ice & Water Final 'y Framing Fireplace: _Rough In Air Test Insulation Meter Size: Reviewed By: Pool Occupancy Code Edition Zoning Stories Square Feet Length Width Final Siding Reroof Windows _ Egress Window Storm Damage Exterior Alteration (Single Family) Exterior Alteration (Multi) Miscellaneous _ Demolish Building* Demolish Interior Demolish Foundation Water Damage *Demolition of entire building — give PCA handout to applicant MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Sheetrock Final / C.O. Required X Final / No C.O. Required HVAC Other: Pool: _Footings _Air/Gas Tests _Final Siding: _Stucco Lath _Stone Lath _Brick Windows Retaining Wall: _ Footings _ Backfill Final Radon Control Erosion Control , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL "76(9)(9,° Page 2 of 2 f.. ' .. - . . . . .. . . . f . . . ? < A M' . ? ? ? -. . .... .r. r , FLOOR DIAPHRAGM 1S TO BE SHEAiHED W1T H WOpD STRUCTURAL PANEL T& G SHEATHING WITH AN ADEQUATE SPAN RATING. NAIL SHEA7HING w/ 8d NA1LS " ? @ 6 O.C. AT ALL EDGE SUPPORTS & ALL T ? SUPPORTS. N STALLESHE A HING ? PERPENDICULAR 7D FLOOR JOISTS & IN A STAGGERED PATTERN (16) lOd NAILS INTO BLOCKING lOd NAILS @ 6" O.C. I R1M TRUSS BY pTHERS 1NSULATION PER CODE ATTACH BOTTOM CHORD OF R1M TRUSS TO S1LL w/ M1N, (6) IDd NA1LS EACH SIDE OF BLOCKING 2 x 6 M1N, WOpD SiLL PLATE SEE S-2 FOR ANCHORS ? WDOD FLOOR TRUSSES--J SEE SHEET S-2 FOR WALL REINFORCEMEN7 BY MANUFACTURER REBAR NOT SHOWN 2 x 4 BLOCKING TpP & BOTiOM ? a SLEIPE GRADE EIF TRUSSES IN FIRST C2? iRUSS 9 a a SPACES AWAY FROM 9 FOUNDAiIpN @'}8° QC, C SAND > OR v >@ 36" D,C. ( SANDY/CLAY ) pR v. L 24" O.C, C CLAY > w/ i- (4) lOd TpE NA1LS EACH END I -I I I I I ? 3/4" PLY1?ppD pNE SIDE IIF i ? ? BLpCKING IN FiRST (2) TRUSS SPACES w/ (8) 8d NAILS TOP W A L L S EC r Ip N g BorroM PARALLEL T? FRAMING rRUSSEs 2007 MASTER CAST-IN-PLqCE CONCRETE FOUNDATION DRAWINGS TRUSS BLOCKING DETAIL RON CLARK DESIGN & CONSTRUCTION 7500 WEST 78TH STREET EDINA, MN 55439 Phcne:(952)9473022 Fax:(g5p)gq7_gQ15 J08EREINFpqµqTpN Ito bB IiIIBy oyt py the clawrytty) Owner: So-eet Amres P?o'?ectNumbm: p51pp' Gity:--? Slate? Zip Co@' Du1e' _ Jannn t 2QT S_A SI?eols' 0 .f 26 1 L Address: 3586 Lemieux Cir. Zip: 55123 Permit: 81390 THE FOLLOWING ITEMS WERENIIERE NOT COMPLETE AT FINAL INSPECTION ON : rN,V U Yes No Comments Final rade - 6" from sidin Permanent ste s- ara e Permanent ste s- main ent ? Permanent drivewa Permanent as Retainin Wall or 3:1 Max Slo e ? Sod/Seeded lawn Trail/curb dama e Porch Lower level finish Deck Fire lace • Verify with your builder that roof test caps from the plumbing system have been removed. • Turn off water supply to the outside lawn faucets before freeze potential exists. • Call the City's Engineering Department at 651-675-5646 prior to working in right-of-way or installing irrigation system. ? BUILDING INSPECTOR: mi/"`" t' n"__? G/Bldg Insp/Forms/2007/Checklists 8 L '. 2007RESIDENTIAL BUILDING PExmrr ArrLicATTONff City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 ?k Telephone # 651-675-5675 FAX # 651-675-5694 S ?rv '?Xl 3 93 3-134o 1-11213:?7q ?l3 9-g- 9a 67Z) lalo.1o, q4 New ConsWdion Reauiements RemodeVRewQ ReamremeMs ONiw Uae Oniv -3 regislered sife siuvays strowing sq. ft of bt, sq. ft. of house; and a0 roofed areas 2 copies of plan showirig foofings, beams, joists CeA oi Survey Recd ? Y_ N (2096 maxunum bt coverage allaaed) t set of Energy Calalations fa heated additions Sails Repat _ Y_ N t Soils Repat if proposed buildmg is Go be placad an di.s4urbed soil 1 site surrey for addtions & decks Tree Pres PIan Recd _ Y-"L-N. -2 capies of plan showing heam & wimlow s¢es; poured found design, e1c. Addition - tirdicate rf onsifa septic sysfem Tree Pres Requved _ Y2?N ? J set W Energy Calculedions On-m[e Septic Syslan _ Y_ N 3 copies of Tree Preservalion Plan'rf bt pletted afler 711193 'Rm Joist Detall Options selection sheel (buildings Hith 3 ar less unqs) -1Aionepasco mechanical veMilation form Date//? 0'? Coostruct,on Cost I 32 o c? Site Address ?-F'^l ! EU )6 Od A-e(-r- Unit *;?? ,s ? ?, 07 5, Description of Work /Y E ?57RiJGTI O?`L L&t A tl C70r--1-IZ- VP 67' Multi-Family Bldg ? Y V N Fireplace(s) _ 0 izi_ 2 Q'y PropertyOwner FiF44P-L-Monp i He-tGt-t`f'S i LC.-Q. Telephone#(95Z) Contractur A0N 00412-lL (?Dnf ?n2-tl GT7LV.f ?-C)E.S fGA1 Address 7960 1/\( • 78 T'4 r'j"C_ City E D I l?i ill, State Iv `? Zip -'~?S Tclephone #(9Cj2) 94'7- 3ccO COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING I '-/Mi?esofa Rules 7670 Catesorv 1 Minnesota Rules 7672 Energy Code Category • Residentiai VeMilation Category 1 Worksheet • New Energy Code uuorksheet (J wbmission type) Submltted Suhmitted • Enargy Envelope Calculations Submilted In the tast 12 months, " the City of Eagan issued a permit for a similar plan based on a master plan? Y -LZ N If yes, daTe and address of master plan: Licensed Plumber ZE'CA-nf QZ9- NL 6,D-}-f}-nC l eo4C- Telephone #(952, f45' 4?Z. Mechanical Contractar CLAti1 P(F.e- Mr&4.4/`? teplt- Telephone #(9y2) 44 S- 46> 92 Sewer/Water Contractor !?AnfCff l_DPPI ? Telephone # (7S2}!f 72 ` Z'J 11?o -&/Z "_Z`f0 • K4:,2 20 / I hereby apply for a Residential Building Permit and aclmowledge that the information is complete and accusate; that the work wil( 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 stazt without a pernut; tha# the work will be in a.ccordance with the approved? in the case of work wluch requires a review and approval of plans. / 10, 9'q!31 F3 -T,4J! lL-- ?r ? Applicant's Printed Name p icanYs ignaiure ' • DO NOT WRITE BELOW TffiS LINE • . . Sub Tvpes O 01 Foundation A 02 SF Dwelling ? 03 01 of _ plex ? 04 02-plex ? 05 0.33-p1ex ? 06 04-piex 0 07 05-piex ? OB 06•piex ? 09 07-plex ? 10 08-plex ? 11 10-plex C3 12 12-plex ? 13 i6-pleu ? 16 Fireplace ? 17 Garage E3 18 Dedc O 19 Lower Level ? 20 Pool O 30 Accessory Bldg O 21 Poroh (3sea.) C] 31 EXt. AR - Multi ? 22 Porch/Addn. (4seaJ O 33 Ext Alt- SF ? 23 Porch (scxeen/gazeboJpergola) ? 36 Mutb Misc. ? 24 Storm Damage Q 25 Miscellareous work Types 31 New ? 32 Addition O 33 Alteration O 34 Replacement ? 35 Irrt Improvement O 38 Denolish interiw ? 44 5iding ? 36 Move Building 0 42 Demolish Foundation O 45 Fire Repair 13 37 Demolish Buiiding• ? 43 Reroof ? 46 Windows/Doors •DemWlitfon (Enfte Bidg) - Give PCA hantloutlo applkaat Description: Wa4er Damage _ Yes Valuation Occupancy ? MCES System - Plan Review 100% or 25% Census Code /0/ Zoning RD_ City Water SAC Unks 0/ Stories ? Booster Pump •*?o # of Units Sq. Ft. .2-306 PRV ??O # of Bldgs o/ Length -75_ Fire Sprinklered Type of Const ,/3_ Width 40_ REQUIRED INSPECTIONS ? Footings (new bldg) ? Sheehnck _ Footings (deck) ?G FinaUC,O. Foo6ngs (aildition) _ FinaUNo C.O. ? Foundation _ HVAC Drain Tile Other Roof ?I Ice & Water ?G Final _ Pool _ Ftgs Air_!?'ias Tests Final ? Framing Siding _ Stucco Lath ? Stone Lath _Brick Fireplace ,± R.I. _yAir Test SFinal ? Windows ? ? Insulation _ Retaining Wall Approved By: , Buitding Inspector Base Fee ? ? 1/.? /'?%y ? 4- So 2 Surcharge Plan Review /D ?.(.?' ? s 1709 ? 79 r a,Z ? ? 36y ? MC/ES SAC 41?1 30 City SAC Utility Connection Charge ? ? ,' ?r t / 3G C? ?? ? o+ ? S&W Permit E? Suroharge ? x y Treatment Plant ? ?? License Searoh Copies p ?- Other Total ? . ... • INSULATION INSPECTION CHECKLIST FOR RESIDENTIAL BUILDING PERMITS /1 ng ?- PROPERTY LEGAL: /f,-" 3 PROPERTY ADDRESS: 3J `? 6 ?e M? L' ?,? ? Ci yC.I f INSPECTOR: Zcati) p : l(,W ? INSPECTION DATE: Ii - <<'1- d00, m o a ? z z SITE GRADING ?? ? AlI slopes 3:1 or flatter? "? ?? Slopes steeper than 3:1 require retaining wall. Are retaining walls present? ?? ? Does grading conform to As-Built Grading Plan (+/- 1 foot approximately)? ?? ? Does perimeter grading tie in well with adjacent propertieslundisturbed land? ?? ? Is there proper grading and/or drainage around Lookout or Egress Windows? EROSION CONTROL ?? ? Is Silt Fence (or approved equal) installed and in good working order? ?eMp Ve6 ?? ? Is Sod/Fiber Blanket installed behind curb? ReMVofej ?._ ?? ?3? Is the Rock Construction Entrance/Driveway installed and in good working order (proper typelsize of aggregate, clean-not covered with soil, etc.)? ?? ? Is temporary vegetative cover w/ muich present? ?? ? Is permanent vegetative cover w/ or w/o mulch present? SD?? (circle one) CITY EASEMENTS AND UTILITIES ?? ? Are all easements clear-no part of any building/deck/porch/retaining wall/etc. encroaching in easement? ?? ? Are catch basins present within the property or in the street in front of the property, if so are they clean, do they have the proper erosion control in and/or around them? ?? 0 Does the property have an Emergency Over Fiow (EOF)? This can be found on the Certificate of Survey. If so, is it present and has it been graded properly? MISCELLANEOUS ITEMS ??? Is there tracking present on Public Right-of-Way/Street from construction site? ??? Is the driveway at the proper width at ROW line? (22 ft. max.)(Curb stop is at ROW line) ? 0 11 Is the site clean, no trash and/or construction debris lying around? ?? ? Was the proper type of building constructed according to the approved grading plans? (LO, WO, FB, R, etc.) LOT SURVEY CHECKLIST FOR RESIDENTIAL ;_ .. BUILDING PERMIT APPLICATION , PROPERTY LEGAL: ?O4 S & ? ? .? ? I ?J??'I fln^I' Yt?i6??S DATE OF SURVEY: /?ZId-7 LATEST REVISION: m rn c ? r U ? Q O z ? Q DOCUMENT STANDARDS rY ? ? • Registered Land Surveyor signature and company ? 0 ? • Building Permit Applicant p ? . Legal description 0 0 • Address ? ? ? • North arrow and scale z ? p • House type (rambler, walkout, split wlo, split entry, lookout, etc.) ' 10 ? 0 • Directional drainage arrows with slope/gradient % ,9' D ? • Proposed/existing sewer and water services & invert elevation 'R 0 0 • Street name ,g ? ? • Driveway (grade & w(idth - in R/W and back of curb, 22' max.) ? ? ? • Lot Square Footage ? ? ? • Lot Coverage ELEVATIONS Existin ? ? 0 • Property comers ? ? • Top of curb at the driveway and property line extensions ?13 ? ?. • Elevations of any existing adjacent homes ?X ? ? • Adequate footing depth of structures due fo adjacent utility trenches ? ? • Waterways (pond, stream, etc.) Proaosed ,Pl ? ? • Garage floor 'z ? ? • Basement floor .0 ? ? • Lowest exposed elevation (walkouUwindow) g ? ? • Property corners ' '0 ? ? . Front and rear of home at the foundation PONDING AREA (if applicable) ? jg ? • Easement line ? ?1 ? • NWL ? ? ? • HWL ? J0 ? • Pond # designation ? f ? • Emergency Overflow Elevation ? f,Z q • Pond/V1letland buffer delineation Y . Shoreland Zoning OVerVay District . Y U • Conservation Easements DIMENSIONS ,g ? ? • Lot lines(Bearings & dimensions 'g ? ? • Right-of-way and street width (to back of curb) ?e ? ? . Proposed home dimensions including any proposed decks, overhangs greater than 2', porches, etc. (i.e. all structures requiring permanent footings) '0 ? ? • Show all easements of record and any City utilities within those easements ? ? ? • Setbacks of proposed structure and sid d setback of adjacent existing structures ? ? ? • Retaining wall requirements: Reviewed By: ? .? Date G:/FORMS/Bui lding Permit Application Rev. 71-26-04 -44 City of Eaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 AUG - Use BLUE or BLACK Ink For Office Use Permit#: /60S7 Permit Fee: 69k,e F6P-- Date Received: ?"8"---i9 Staff: 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit R SIDENT / OWNEI _.� 1. S i ,is ci -,c--s-(S7, Name: 1J' le. -s J. fr O L(e_ Phone: 4 '— i Address/City/Zip: (r' Le' sei-1X tet- k- :g7Gel 6-S-701el. /Owner &pale r4.f r Applicant is: ✓r Contractor 0 `�P TYPE OT WORK " Description of work: V aCC 4 lot. CO 0.S- 1''4 C�Gd t»t 10-� l e. U /ir d„C..6 Construction Cost:11 S 106 Multi -Family Building: (Yes / No)(' ) CONTRACTOR Company: Contact: Address: City: State: Zip: Phone: License #: Lead Certificate #: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) In the last 12 months, Yes No If COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING has the City of Eagan issued a permit for a similar plan based on a master plan? yes, date and address of master plan: Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: Phone: Phone: Phone: NOTE `Plans and supporting documents that you submit-are,consrdereto bye public information Portions bf the information maybe classified as non-pubhe rf you ,provide specific. reasons that w would permit the `ity to k:: conclude that they 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.gopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I 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 plan x c r C.S �l , 1-77 e-, Applicant's Printed Name x Appljtant's Signature Page 1 of 3 DONOT W BEWW THFS IL NE SUB TYPES _ Foundation Fireplace Porch (3 -Season) Storm Damage 3 Single Family Garage Porch (4 -Season)— Exterior Alteration (Single Family) Multi Deck Porch (Screen/Gazebo/Pergola) Exterior Alteration (Multi) 01 of Plex Lower Level Pool _ Miscellaneous Accessory Building WORK TYPES New Addition Alteration Replace Retaining Wall 4Interior Improvement Move Building Siding Demolish Building* Reroof Demolish Interior Fire Repair Windows Demolish Foundation Repair Egress Window Water Damage *Demolition of entire building - give PCA handout to applicant DESCRIPTION Valuation 7 400 _ Occupancy ,r/PC, - 2 MCES System Plan Review Code Edition Hari? SAC Units (25% 100% Zoning /gyp City Water Census Code 1130 Stories — Booster Pump # of Units Square Feet _ PRV — # of Buildings — Length Fire Sprinklers Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final / C.O. Required Footings (Addition) it Final / No C.O. Required Foundation HVAC _ Gas Service Test Gas Line Air Test Drain Tile Other: Roof: Ice & Water _Final Pool: _Footings _Air/Gas Tests Final Framing Siding: Stucco Lath _Stone Lath _Brick Fireplace: Rough In Air Test Final Windows Insulation Retaining Wall: _ Footings Backfill _ Final Sheathing Radon Control Sheetrock Erosion Control Reviewed By: (!fir 1 , Building Inspector RESIDENTIAL FEES' Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL /Y 7 3 33 �o b0'°"-- Page 0of Page 2 of 3 4,1°1 CityofEa�all Date: 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Pennit #: 113951" Permit Fee:` d ✓ •gas Date Received: ` ` 1 113 Staff: n 2013 RESIDENTIAL BUILDING PERMIT APPLICATION VI Site Address: 3 S2q - 3 SEC L.R✓". t 02.-J+ - unit#: J 12 1 � Name: Per.. -e -!t `' 9s- Z- ,-1 - 30 1 �.,�i % Q.SI�� t-►�,r�Q oc.��s w.SP Phone: Address / City / Zip: Applicant is: Owner ( Contractor Description of work: Goer' O C(- ' /fit- - 1/41/ sf A f+c Construction Cost At 3 ,573---0 419 Company: Multi -Family Building: (Yes / No SzkQ FTA J G --i C - Contact fl S+ -1•01,..1e1 -„L_ Address: ! 0S r://4I.1-e-- /1/111/ , City: LaLk 'l \ Wt State: O 10 Zip: S S'4 2_ Phone: (�S)— i77 -1y1 \ License #: (3C.. ''I J1 j'/ Lead Certificate #: 0417-. /I3%- 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 considersed to be public information. Portions of the information. may be classified as non ublic 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. wrww.ciooherstateonecaU_orq 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' caw, -Sk-r L k: r�L Applicant's Printed Name x Applicants Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA172279 Date Issued:09/23/2021 Permit Category:ePermit Site Address: 3586 Lemieux Cir Lot:5 Block: 03 Addition: Pearlmont Heights PID:10-56950-03-050 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Softener Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087 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 - Christina A Foye 3586 Lemieux Cir Eagan MN 55122 (651) 454-5586 Milbert Company (culligan) 1801 50th St E Inver Grove Heights MN 55077 (651) 451-2241 Applicant/Permitee: Signature Issued By: Signature