1553 Antler PtRESIDENT /
OWNER
Name: Phone:
n //
Address / City / Zip: /,5,4 4AJ h k // ZA 9M iJ 55/ 2 2
Applicant is: Owner e Contractor �� c(,iz1O$ 0 --/- 1 5S 3
TYPE OF WORK
Description of work: I F /ADC
Construction Cost: 1 .2, b d 6 Multi- Family Building: (Yes / No )
CONTRACTOR
Company:Arne —C E IG RE5 crAt Contact: OWE gorirtEl
Address: /7. /,' , en.,-412-7 Ote, ( City: ►�"„
State: Ali.) Zip: 557P *' Phone: 7 tc, " 1 120 3 /0 `2
License #: QO/ 5 Lead Certificate #:
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 documents that you submit are considered to' be public info rma #ion Portion of
fh information may be classified as non- public if you prov specrpc seas tifat would perm the 'City fo
'' conclude:that they are trade secrets ., .
4 CityofEa�an
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
x L W oa
Applicant's Printed Name
Cc
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address:
CALL BEFORE YOU DIG. CaII Gopher State One CaII at (651) 454 -0002 for protection against underground utility damage.
CaII 48 hours before you intend to dig to receive locates of underground utilities. www.gooherstateonecall.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, 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 -is proval of p
Applic 's Si • r:ture
Permit #:
Permit Fee:
Use BLUE or BLACK Ink
q / 1 / 6 /
$ 0( 5 O
eived -&
Unit #:
Page 1 of 3
zJg
Use BLUE or BLACK Ink
r - - - - - - - - - - - - - - - - -
I For Office Use L~
Permit `
ing
City of Ea
Permit Fee.
3830 Pilot Knob Road 7
Eagan MN 55122 Date Received:=1d
Phone: (651) 675-5675 I7
Fax: (651) 675-5694 I Staff:
I I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: ( l Site Address: 1417o'l 40, ! t'~ r Unit
Name: i t P lJ U 76A,_),AJ {f'dmf- //fS,S Q .d"l9'T;1~cX Phone:
Resident/
Owner j Address / City / Zip:
Applicant is: Owner Contractor
Description of work: )eCc' 1~~ v~G Cis cL'~✓
Type of Work
Construction Cost: Multi-Family Building: (Yes / No )
-nLc
La~r~I/i~L
f ! /"l u t~ C tCompany: Contact: /4-1,
Address: City:
Contractor
State: Al/L-, Zip: Phone: -76 ? 4120 - S% 6 .7
License b CiLead Certificate 5~ ~~Gt>G~
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
J__7L,T_ TrIe- 8 l796
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 considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
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 M
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 plans.
Exterior work autho ' ed b a building permit issued in accordance with the Minnesota State Buildin de must be completed within 180
days of per s ce Lr~
x x
Applican ' ' ted Name Applicant' ignature
Page 1 of 3
t*
City of Eagan
Date:
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
13
r
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee:
0-01/L
Date Received:
Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
/243)/3
Name:
Site Address: l 3-5— 3 4N %% A
Lr' r r -r
Resident)
Owner
Type of Work
Address / City / Zip:
Applicant is:
ref r 6464,--) kip/Unit #:
/53-3 ON
Phone: C/a- 3g 4-921
/ - Owner
Description of work:
Construction Cost:
Contractor
LL
(2, `zSv®o
Company: De
Lv!J 4.04 -
Multi -Family
04 -Multi -Family Building: (Yes / No )
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)
12-3 tot o
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:
Phone:
Phone:
Mechanical Contractor:
Sewer & Water Contractor:
NOTE: Plans and supporting documents that you submit are considered to, be public information
the information may be classified as non-public:if you provide specific reasons that4iilOiSr permit
conclude that they are trade secrets
ions o
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.gopherstateonecall.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 l 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 09"-2 ' \
Applicant's Pri ted Name
x
Applicant's Sigy(ature
Page 1 of 3
SUB TYPES
Foundation
Single Family
Multi
01 of Plex
WORK TYPES
New
Addition
Alteration
/ _ Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25%_ 100% ' )
Census Code
# of Units
# of Buildings
Type of Construction
/553 /417:1-1&r pf
DO NOT WRITE BELOW THIS LINE
Fireplace
Garage
Deck
Lower Level
Interior Improvement
Move Building
Fire Repair
Repair
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Drain Tile
Roof: Ice & Water _Final
yt, Framing
�� Fireplace: Rough In Air Test
Insulation
Sheathing
Sheetrock �i1W
Reviewed By:
Porch (3 -Season)
Porch (4 -Season)
Porch (Screen/Gazebo/Pergola)
Pool
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
Final
Siding
Reroof
Windows
Egress Window
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
Accessory Building
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
Meter Size:
Final / C.O. Required
Final / No C.O. Required
HVAC Gas Service Test Gas Line Air Test
Other:
Pool: _Footings _Air/Gas Tests _
Siding: _Stucco Lath _Stone Lath
Windows
Retaining Wall: _ Footings _ Backfill
Radon Control
Erosion Control
, Building Inspector
Final
Brick
Final
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
vif,a1.411'
9Oyo
Page 2 of 3
Use BLUE or BLACK Ink
r
For Office Use
5n~
City of Ea an , Permit
R
I Permit Fee:. ~ I
3830 Pilot Knob Road I r
Eagan MN 55122 Date Received: I
Phone: (651) 675-5675 j Staff: Ing
I
Fax: (651) 675-5694 L
J 12014 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: L/ ~L 1 J Site Address: 5 5' 1 e r r P, "j
/
Tenant Suite
I
E Name: Phone: Z- 3 z
Resident/Owner
Address / City / Zip: 2zZ
Name: License
1
Contractor Address: City:
i
State: Zip: Phone:
f Contact: Email
Type of Work New -Replace-:enter _Repair -Rebuild - M ify Space - Work in R.O.W.
Description of work: S t c S I fi~✓'4 75~~---- -
RESIDENTIAL
I
E
Water Heater
Water Softener
Lawn Irrigation L- RPZ / PVB)
Permit Type
Septic System tumbing Fixtures Main /mower Level)
New Water Turnaround
Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$60.00 Lawn Irrigation (includes $5.00 minimum State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround" (includes $5.00 State Surcharge)
"Water Turnaround (add $200.00 if a 5/8" meter is required)
$115.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
TOTAL FEES $
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 pl
x~
Applicant's rinted Na a Applicant's gnature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Rough-In Air Test Gas Test Final
Meter Related Items: Meter Size Radio Read Staff:
Use BLUE or BLACK Ink
r________________^
I For Office Use �
. � . ia3 �i� �
City of ����� � Permit#. �
� ���. �...5 �
� Permit Fee: �
3830 Pilot Knob Road � �P – ��,
Eagan MN 55122 � Date Received: �
Phone: (651)675-5675 I I
Fax: (651)675-5694 I Staff: I
I I
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: !S-S� �� `�"�� �� Unit#:
I Name:��y f1�,� Phone:
Resident/ ��—
(jyy�g� ' Address/City/Zip: ��3 �n��tr
�` `�• ' � ��' �� Applicant is: Owner Contractor
� � � � �� Description of work: �e Si�1� rb �L+ri n���^-S
T��e !}f W�rI�
' Construction Cost: � f.�GGCi — Multi-Family Building: (Yes /No�
' Company: /�nu�,2�,n ��,Ie Contact: Gy� �����
�
' ' Address: r2�7� 3��� City: `�✓h/� �ti� �,�C�
�O1'1�t'1C�O'f�
,.; ' State: �'I�/Zip: ��� Phone: oC �fU'J/��Email:
' License#: � �� Lead Certificate#:
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:
NOT'E:Plar�s and sup�tarting,dcicr�ments�hat�r�u submit ar�cr�nsia►ered#�be publ�c ir�fc�rmatron. Portiorrs of
fh�inform�atian'r�taji�e classifie�t as rron��iblic r`f yau;prt�viafe specet`ic:reasons#fiat wr�ufd p�ermit the Cr"#y,#�
' ��nclude�ha�.#he .�are€raale s��ret�.
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.aopherstateonecall.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 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.
/�j _�_..._
X / liG��� C� X �
Applicant's Printed Na Applican Signature
Page 1 of 3
Use BLUE or BLACK Ink
. r-----___-_
------� ���
' I For Office Use �� �
�� � � ��� � � �
C�} �� �� �� � Permit#: � (
6� � � ��
� Permit Fee: �� ��� I
3830 Pilot Knob Road �
Eagan MN 55122 � Date Received: �/o"/� �
Phone: (651)675-5675 - : ,�, ;a' I I
Fax: (651)675-5694 I Staff: I
,` I I
�ui;� -----------------�
2015 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: / ����5 Site Address: I-SS3 ��'I��P�" �d�h� Unit#:
'��'� Name: � Phone:
R+�s#d�E1#1 ��
Q�y�f;� Address/City/Zip:
Applicant is: Owner Contractor `
� � � �� � Description of work: �r/�7 ' (G��� 1 vj� �'� ��� ���L-t� �N�v /�°'S�J�
Ty��; Qf I�IOrk `
Construction Cost:� ��8�� ' 0� Multi-Family Building: (Yes /No�
Company:.�E�t� �►"�S'�Or� Co►�� • �rl�. Contact: �Pt�" ��PST��
Address: ���� �. S�G� i' s�. City: U����P / l�i/!Z'
�4�t�a�"l'01` �
' State: J'�� Zip: -rd d l Phone: )6T�Z Z S"�`�F Y Emai�: ,�c���i- 7a7 y� �//�� . C O r^-�
: License#: �C �' 97 p?.�I Lead Certificate#:
If the project is exempt from lead certification, please explain why:
%3r�i l� ; •� /99� �
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 8�Water Contractor: Phone:
Fire Suppression Contractor: Phone:
: N��"�`:Pla�s��caf sirp�tt�r�r���a��r�fs���#;�c��r�wb���a��a�r�reral#v b�p�rtili���'orr��#�ctt� l�o�r%n�o�' '
' tl�e�rr�'otr�tatir�a r��y#�cla�i#ied,a�r�i�»p�bf�c�';�o�r pr��rle�pec�'��reas�r�s fhaf uu�c�p�er�i#i�e Cf��a
c�r��al�d�e�at tfie a�e�ra�al��ec�efs. I
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.qopherstateonecall.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.
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 J Q�-� ���'s���h X .__
Applicant's Printed Name ican ' Signature
Page 1 of 3
`�`�� f'�I;l�.-���. �� DO NOT WRITE BELOW THIS LINE � �����
�—
SUB TYPES '
Foundation Fireplace Porch(3-Season) _ Exterior Alteration(Single Family)
Single Family Garage _ Porch(4-Season) _ Exterior Alteration{Multi)
_ Multi � Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous
01 of Plex Lower Level Pool Accessory Building
WORK TYPES
New Interior Improvement Siding _ Demolish Building"
_ Addition _ Move Building _ Reroof _ Demolish Interior
Alteration _ Fire Repair _ Windows _ Demolish Foundation
�, Replace _ Repair _ Egress Window _ Water Damage
Retaining Wall '`Demolition of entire building-give PCA handout to applicant
DESCRIPTION (� ,
Valuation �t/' Occupancy f,. MCES System
Plan Review Code Edition ��,n�,�� SAC Units
(25%_ 100%�) Zoning �_ ` City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction �� Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
� Footings (Deck) Final/C.O. Required
Footings (Addition) � Final/ No C.O. Required
Foundation HVAC_,Gas Service Test Gas Line Air Test
Roof: Ice &Water Final Pool: _Footings _Air/Gas Tests _Final
Framing Drain Tile
Fireplace: _Rough In _Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick
Insulation Windows
Sheathing Retaining Wall:_Footings,_Backfill_Final
Sheetrock Radon Control
Fire Walls Fire Suppression:_Rough In_Final
Braced Walls Erosion Control
Other:
Reviewed B ��� Buildin Ins ector
y: � 9 p
RESIDENTIAL FEES
Base Fee ,�
�� �
Surcharge �,.�� ���a �"
F `� �
Plan Review ���z; v= �
MCES SAC �'�„� 9"�
City SAC �
,.,�° ��~
Utility Connection Charge k
� � �
S&W Permit&Surcharge -�
Treatment Plant
Copies
TOTAL
Page 2 of 3
. � �� -• CERT FICATE 4F SURVEY
' ��"' �-- for � � � ��7
/�� � �n-+(��
G04D VALLJE HOMES
,,
� ` PROPOSED BUILDING ELEVATIONS
X q/v" 905�8
'T�p of foundation !_wL•5___ Front,of house --
���Garage�floor C1•U____ Rear of house �OD•_7b �
Lowest floor ����_� Walkout NZ�______
`� '� `'c�trow denotes drainage direction per development plon.
�t J ' �' � �R�
� �< 890E denotes exisiing spot elevation
890P denotes propased spot elevation + �
�y,� ._� ,� � S,
� �9�•v S
' b � ... .. 8 4� ��O� �0�8� �.
'ry '1 0,� 8
� �'_ e�����.d�,. �s ,ry >S o F
- � �
��' ..Y .33 Q�ry 3 � �
� ��� ^ S�� O� U
�..�t�J _ `�v rya z8 08 0.
.� .�� 17 � 'S �
�� � � 3�
.�� bc t0 � � ?8�8��ry S8
s,
��' `y � '�°j pR $ ^ 8�
�v Q���j `y e \ To���o '� p \ 7
Y . OM�c p ryp.
Detail (typical) a Gj� rRopo
Not to Scale �� �� ,�� ,, �'yoMF /J a 5�°����
8 �`°���' ,�� �
��� � ¢� / � ,�r.]\ � �
�
,s�o/s co � sss / � M�-'�ry
e�u�y�,woP. 4 / � �,� �'R � � �' r�
�b cRps b Q� ti
�J��(p �A� A �CF�� P e �' �1,� -
�q�,0 ,3 ?04� �R°q°�e�.o Ui
I ��0 h 2og ryo /
Jtar,rF��t.� aWF1T�.� i � /
S��Vlc�S � �.�' , P•�� 0�=. /ss
-1"�l�IUS� T � c�` �- 63°,��� 35 "- �9 @4' �
. ,� _3�
B 848.. o � ,
T ' • � U
13'O/5 lo
�AGAN I�:NG "_..i i `ItiG DE`'t"1'. � G�03� ��05� eonaero��eve'
5 Sn�• S6�.V� �L-= �{y.S+
� .�\���w` ENCHMA K USED:
I I �\��,v��� T�P o-R R.b.l.v, n7U►�v7�LNT SO.Sli]� 4-�
4���G L��.wOof� ��..@67�37" �LATL�NE �X7�.��Gfl
�o��' �.c...��Roq.�3
NOT�: ALL DIMENSIONS ARE FOUNDAl10N DISTANCES LEGAL DESCRIPTION
( ) = RECORD INFORMATION
O DENOTES 1/2" IRON PIPE & CAP SET Lots 17 and 18. B1oCk 1, DEERWOOD
L.S. # 23945 TOWNHOMES, according to the plat of
� DENOTES IRON PiPE SET - f6COfd thCT80f D�kOtCl County, Minnesota.
FOR BUILDING OFFSET I hereby certily that ihis survey was
❑ DENOTES WOOD LATH 5ET prepdred by me or under my direct
FOR EXCAVATION ONLY ' supervision, and that I am a duly
DASHED LINE DEN07ES DRAINAGE Licensed Land Surveyor under the
AND UTILITY EASEMENT AS PER P�,4T. �aWs of state of Minnesota.
PA98E FSIGINEEAIN(}. INC. Oona�d E.,Si et MN L' o. 23945
AEt3I9TER8A PROFESBIONAL�LAND $URYEYORS . 9 Y�
9448 EA9T RI�R ROAD, 3UITS Y48 I Date: /����
CODN RAPID9, !dN 66498 �
Tei. (813) 7d6-BYlO Fa7t. 181� 7b6-1881
JOB N0: 93-34 SCALE: 1 INCH =__20__FEET FIELD BOOK: PAGE: DRAWN BY: CKP
DEfRCRT2.DWG
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA168877
Date Issued:05/06/2021
Permit Category:ePermit
Site Address: 1553 Antler Pt
Lot:17 Block: 01 Addition: Deerwood Townhomes
PID:10-20200-01-170
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 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 -
Gary H & Cynthia A Raynor
1553 Antler Pt
Eagan MN 55122
Renewal Andersen
1920 County Road C West
Roseville MN 55113
(641) 264-4088
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA172191
Date Issued:09/20/2021
Permit Category:ePermit
Site Address: 1553 Antler Pt
Lot:17 Block: 01 Addition: Deerwood Townhomes
PID:10-20200-01-170
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 -
Gary H & Cynthia A Raynor
1553 Antler Pt
Eagan MN 55122
Haley Comfort Systems
3708 Broadway Ave N
Rochester MN 55906
(507) 281-0138
Applicant/Permitee: Signature Issued By: Signature