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3855 Heather DrRESIDENT / OWNER Name: Pal 1 eti Phone: (a ci - 06 - q as Address / City / Zip: CONTRACTOR Name: e,R( LA Ai A 2 License #: _Aim Address: 1101C 7 0 4't /l/ City: c le. I? Ili t✓Z. State: ,M..A/ Zip: Cs Phone: 60 - ; 8) - - 7F& U Contact: -- To RAI Email: ` (jLv., d 0` // M.ltitlrti @ A4 i/v- (ova. TYPE OF WORK )4 - New Replacement Additional Alteration Demolition Description of work: Iti s 1 N et, #,JLNM„ E / 47(, s NOTE: Roof mounted and ground mounted mechanical eq is required to b screened by City { Cede:_ Please contact the Mechanical Inspector for;information permitted screening PERMIT TYPE RESIDENTIAL Furnace COMMERCIAL New Construction Interior Improvement /-- Air Conditioner Install Piping Processed Air Exchanger Gas Exterior HVAC Unit Heat Pump Under / Above ground Tank ( Install / Remove) Other ** When installing /removing tank(s), call for inspection by Fire Marshal and Plumbing Inspector RESIDENTIAL FEES: $55.00 Minimum Add -on or alteration to an existing unit (includes bumed out appliances, ductwork, etc.) (includes $5.00 State Surcharge) $5.00 State Surcharge) $ TOTAL FEE $95.00 Fire repair (replace COMMERCIAL FEES: $75.00 Underground tank $55.00 Minimum (includes installation /removal OR State Surcharge) $10,010, surcharge is $ 5.00 surcharge increases by $.50 for each $1,000 Permit Fee requires a $ 5.50 surcharge) Contract Value $ x 1% _ $ Permit Fee - If the Permit Fee is less than Fee = $ Surcharge - If the Permit Fee is > $10,010, (i.e. a $10,010- $11,010 Permit = $ TOTAL FEE C!tyofaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 x >bpf kA6KAUA x po65 Applicant's Printed Name Appli -ant's Signature Permit Fee: Use BLUE or BLACK Ink 1 cx) Date Received: Staff: r� 2011 MECHANICAL PERMIT APPLICATION / Date: ' J /( Site Address: TcS [le AA 2 ft Oit v2 Tenant: Suite #: 1 J 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.gogherstateonecall.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. Under Ground Rough In _ Air Test , =Gas = S ervice Test Exterior HVA Obi' ea `_Finn FOR OFFICE US Required inspections S creening inspection WATER SERVICE PERMIT i4S nob Rood P ERMIT NO.: t� Eoi an, iwlN 35122 DATE: 5 Zoning: PIV ; - No. of Units:j 1, unit 't n h s0 . Owner: To llefson Builders Address: Site Address: 3855 11 then Drive L 3 B1 Briar Hill 4 Plumb nobnz..a'R•an •,, ''t Meter No.: Connect)on.Charge: 4 pd Size: Account I3eit• 1 +• ) l` Reader No.: Permit Fee: ^1 ' led i ogre* to comply with the City of Rogan Surcharge: • 5t) pd Ordnonces. Misc. Charges: 60.00 pd met 4: Total: s By Dote Paid: Date of Insp.. L/ Insp.- cr CITE - iit ' EAG... SEWER SERVICE 4. c ; Knob Road PERMIT Egon, MN 55122 ATE: Zoning: PERMIT NO.: S 77I . 1IEi DATE: '^-- _._.�__ Address: ddress: Site Address: 385 $ @,3t i Plumber: Genz R an ive L Bit 'fa i i agree to comply with the City of Ea : ► : " Ordinances. — Eagan Connect C r & 5(t 0 - ,d Account Deposit: 7 Permit Fee: 10 • f BY / " Surcharge: rn d • Dote o ' '�' Misc. Charges: Insp.. S Total: ti. y Dote Paid: the BLUE or BLACK Ink I , for OF" U" i C-1 ties to I PVTM of latan I Z,5~ -1,77' bill ragan 100 Received Phone: 6651) STS-Wra FM (661) mom 2013 RESIDENTIAL BUILDING PERMIT APPLICATION 13pte: 10-ILl- 1.3, 3bAddrm: ~8y4, 38s~, aF~s3; 38.rS- H6f77/014-tZ DR• 'Unit#; Narne: ~~o A G 7" AV r4 A3 A 4 ~ /4 L AJ -r e- Phone: -7" -.sr9 3 0 Address! City I Dp~Sb ~j i4'---v e 19 gaE.S U101, Applicant la: -owner K Contrawr `7r'ER,2 O (QE - IMF Construction Cost Mull-Fam4 Building: (yes -K I No Company: E 1 ~a~ 7-L2ro~ Alt h,,~ eAap Contact- b^i/ A %a (?Jo S Addr //oS 6D S~ , Gp, JylQG 5 State: )FYAI zip: Irryi Phone: !o'z - r'~ G Z y LJoense *t 8 C A q1J 3 / Lead Coriiflcats rk If the project is exempt from lead cmdficadw, phase explain why: (see Page 3 for addldonal Information) RL~ws tJ::e~.' r Post 1 p7 Sr COMPLETE THIS AREA ONLY IF CONSTRUCTING A NIRN I&DING In ehe t 12ma+Mq. has the qq o/ Eagan fastrsd a permit for a slmUar plan lased on a ntwar plan? Yes No It Yes. date and address of meftr plan: Licensed Plumber: Phone: MschanloW ConpgcW: Phone_ Sewer S Waist contractor: Phone; Now--- 11 pill tfre:jfiia W" you k"'d 1104iEiia~ a Can Goptwr Sbla oft am at (661) 45a0o02 for mvwwon against underground u ft damoga Call 48 hours y locates of undwWamw LdItiee. %mft +e n.ora e hereby adub'*0 d1m On wftrQ6ap Is - Eagan; ft I w* st&W this is and &=n* that to VA)* will to in wribramw with to ardkrencas and codes of the Oty of aaeauaMW wdh Ow not a rppner,.a pl,,, in m bd an. aAD iorl for a Aerml and wont is not to Seam wldmA a oennix ow the work vA bs to Uqukcs a slew Ow appmw of plan, &bd*r work ft*-wft*4 by ~ of Pmt lmuarrom a twilling permit Issued in accordance with tM IAtmeeott Stft ftUm Code must be complebd wWn 180 ~jiv11J ~u RR rS Applicant's Printed Warne Appllcaneg Slgnotum Pate 1 of s 5O/bO 39Vd iNIdW 1X3 I3H L9Z9T98ZT9 69:ST £TOZ/bZ/OT Use BLUE or BLACK Ink _ - I For OM CO U30 ----I 1 My of ~ Pem,rt ~ I Ealan I I PemtiE Fee: I 3830 POot Knob Road j l Eagan MN 66122 i pate Received: Phone: (651) 6756676 1 Fax: (651) 67411-6694 S'taQh j 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date; 3 Site Address: 3$y9 3 Ys', 3 95I, 3 fss" &,*7-WeA Unit Name: alb r✓ In.44 4 & is m x 4 j . ~ ~ r✓ Phone: 76 3 - SrJ 3 ' 9 7 7 Rt i~ertt/ S O QSc~s~-u2 Ate, A) 14 GoGD£u 1/*a'X Y /n.) Owner Address/ City ~ Zip:, ~ Ss y~ 7 Applicant is: Owner ,Contractor O71':~Af01'K Description ofwoek: Ps-ou c a, RE Pt .Kt~ S~ d /C, d > ,a-x a ly1 £ r •e L Typo' . Construction Cost / y 410D CFO Multi-Family Building: (Yes ~ / No Company: Q E 1 ~`,r r 6e v 2 IY~*-i .~`r . do 10 Contact: DA tJ 14 I(~~ 22i S Co>ttacvr address: /o w ~o S~ City: M Pz. S State: /V-*~ Zip: Phone: log .L - 9 /v Co V/3 License fP: 4 C v p lead Certificate If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) qt-N&S- QIiLr Posy /5'-2, COMPLETE THIS AREA ONLY I 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 S Water Contractor. Phone; NOTE: a>nd iAI~Y •sti'br~1['~r 1Ni>t•~e• vamF" • tlr~:prarr!oins?loni:.~ d~' ~ . t?~ R~;~~. a'P~~ai~tt~, s ° ' ' ji+ ~D::-•: i;' CALL BEFORE YOU [Me. Coo Gopher State One tail at (631) 434-0002 for protection against underground utility damage. Call 48 hours before you Intend to dig to (00010 locates of underground miss. www.goeherstateonecall.om 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 wodt will be in accordance with the approved plan In the case of work which requires a review and approval of plans. Exterior work authorkad by a building permit issued In 11=0rd4noe with the Minnesota state, Suildi daps of permit issuance n Code must be Completed within 180 . x ~~~r ~ ~u2.JLiS x ~ Applicant's Printed Name Applicant's Signature Page 1 of 3 ZO/TO 39Cd 1NICW IX3 I3S L9Z9T98ZT9 60 :ST ETOZ/8T/TT