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3457 Highlander DrRESIDENT 1 OWNER Name: . . _/_., d I , 1 Z) L i L/ Win e : /5r — --� 551 �. /_, / /, t ( . Address / City / Zip: � � (GrfJ � A Applicant is: Owner Contractor TY OF WORK Description of work: �_ #t4 Gt / .4 j • : � V Construction Cost: « r V (1 Multi- Family Building: (Yes y, No ) CONTRACTOR Company: c XJL/4 � 6 6 Contact "LK- A Uf J V Il �.yl �� Address: 410 i City: S I i I2 ,2.,..c State: Zip: C "d`Y w Phone: L�`� 1' &a, / 1 rd) ,� j �j License #: IOSO Lead Certificate #: l \1 [1 I - X) ') ' O' - 1 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 Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: 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: Phone: Phone: Phone: NOTE: Plan an d supporting ocuraents that you.submit we considered to be public information: Portions of the.inforrnation may be.classified as non-public ifyou provide specific reasons that would permit the.City,to conclude that they are trade secrets. Jun. 8. 2011 2:48PM SELA ROOFING 4 CityofEaali 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 Date: M V V1 , Applicant's Printed Name 2011 RESIDENTIAL BUILDING DI I M1T APPLICATION x Applicant's Signature No.6530 P. 29 Use BLUE or BLACK Ink Permit #: C / Permit Fee: lY 33 '/ 5 . Date Received: Staff: J G d ;: ;:: & &, 3-16 / /um5 4 gi6 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 [abates of underground utilities, www.g.gpherstateonecali.ora 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 approv plans. Page 1 of 3 40t. OF EAGAN WATER SERVICE PERMIT .flpt nob Road PERMIT 1V0.: *gin, MN 55122 DATE: ; , `. Zoning: , ? No. of Units: 1 Owner` o x." t_t°;f ., GO id t :`t.liar> Address: Site Address: 34 ? Ei nl, rider rise . L4 -5 B25 :H4 f )"411 ).l i.(:iat €.. Piuxnber. ; Meter No.: Connection Charge: 160 .i°'` Size: Account Deposit: Reader No.: Permit Fee: See 205: agree to comply with the Village of Eagan Surcharge: ' Ordinances. Misc. Charges: ; B / '�� Dote Y Date Paid: Date of Insp. . :,: - '74 Insp.: 1 VILLAGE OE EAOAN SEWER SERVICE PERMIT 3795 Pilo* Knob Road PERMIT NO.: Eagan, MN 55122 DATE: i I Zoning: No. of Units: Owner: 74.13 : "*, a 30,), _. + 401:8 a t = ? ;1..01a Address: Site Address: 3457 Highlands Pr. L4-5 IQ') H4 Plumber: Cot3o3id3ted 100.00 pd 1 ogres to comply with the Village of Eagan Connection Charge : - o d Ordinances. Account Deposit: alidf Permit Fee: 3 a / t6A Surcharge: By: Misc. Charges: Date of Insp.: Total: Insp.• Date Paid: PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA109212 Date Issued:02/19/2013 Permit Category:ePermit Site Address: 3457 Highlander Dr Lot:5 Block: 09 Addition: Surrey Heights 4th PID:10-73003-09-050 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace Comments:Questions regarding electrical permit requirements should be directed to Mark Anderson , State Electrical Inspector, 952-445-2840 Michelle Hansen 308 SW 15th St. Ste 25 Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088 Surcharge-Fixed $5.00 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 - Brian A Jones 3457 Highlander Dr Eagan MN 55122 Upland Heating & Cooling DBA Aspenair 308 SW 15th Street, Suite 25 Forest Lake MN 55025 (651) 982-2626 Applicant/Permitee: Signature Issued By: Signature