3451 Highlander DrRESIDENT
OWNER I
Name; C it 11.f 1u .ti j 1Q L/J hone: /. r 10r ci f7;
Address I City / Zip: � `bl -3(t'& Cf 'f; 1 Vi folv ill 010
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Applicant is: Owner Contractor
TYPE OF WORK
Description of work; / / 11 1 A . i s /. / 47i ." - !
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Construction Cost: .E� a Multi - Family Building: (Yes i I No )
CONTRACTOR
Company: Sai4 iAJ Contact: 64-444 V /1! rte
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( Address;
State: Zip: ,5 ! Phone: gj
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License v Lead Certificate #: A. A50( I
If the project is exempt
from lead certification, please explain why: (see Page 3 for additional information)
In the last 12 months,
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: _
_ Yes
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor.
Phone:.
Phone:
Phone:
NOTE: Plans and supporting.documenits that you : subf ° it are considered to be public. lnformation: Portions of
the informatlon may be. classified as non - public. if you provide specific reasons that would permit the City to
conclude that they.are. trade secrets.
Jun. S. 2011 2:47PM SELA ROOFING
Date:
City of Eap
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675 -5694
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Applicant's Printed Name
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Applicant's Signature
Permit #
Permit Fee:
No. 6530 P. 23
Use BLUE or BLACK Ink
Date Received:
Staff:
2011 RESIDENTIAL BUILDING .l Z PERMIT APPLIC N
Site Address.345 .1 /� r� .) A nts #. P
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.aor herstateoneall.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 piens.
Page 1 of s
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1 agre to . comply with the City of Eagan` Su rcha rg e .0,:i.,
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1 ag ree t o comply wi th the City of Eagan Connection Charge:
Ordinances - Accou Deposit z k
t'e iv ' . F ee
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Surcharge: T — "
BY l isc`ate
Date of lns : t T ota l
. Date
Pa
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55 z
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA168754
Date Issued:05/03/2021
Permit Category:ePermit
Site Address: 3451 Highlander Dr
Lot:1 Block: 01 Addition: Surrey Heights 6th
PID:10-73005-01-010
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507)
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 -
Niurka Castellanos Perez
3451 Highlander Dr
Eagan MN 55122
(952) 994-0485
One Hour Heating & Air
11825 Point Douglas Rd S
Hastings MN 55033
(651) 437-4177
Applicant/Permitee: Signature Issued By: Signature