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3991 Fawn WayCity of Eaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink Permit#: 996/ Permit Fee: $da 7* 50 Date Received: Staff: 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit #: RESIDENT / OWNER Name: Phone: Address / City / Zip: 3g9 F (.".1 Al L347 PAl24AJ 53.722 Applicant is: Owner k. Contractor T*1 CiA c .391 TYPE OF WORK Description of work: PPipc Construction Cost: i,,2, b c 6 Multi -Family Building: (Yes X / No ) CONTRACTOR / /� __ r /11E7L Company:�}A) �)r✓ R }t0.) Contact: VE Ro ^pri,E-$ Address: /75/9_ I2rsv,04/1-7 Ott, F City: ��"_S State: ill of Zip: 55-57 i Phone: 7 t" " 420 'a io License #: Qo/ ,$ 9 i Z 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 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. Cali 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.orq I hereby acknowledge that this information is complete and accurate; that the work wit 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 Applicant's Printed Name x Applica s Si :ture Page 1 of 3 4/11 City of Eau 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 JUN 161012 Use BLUE or BLACK Ink For Office Use Permit #: Permit Fee: 06 Date Received: l0"d(''12 Staff:'! 2012 RESIDENTIAL PLUMBING7-awn PERMIT APPLICATION Date: (.l7 ' 3-i Site Address: 3l q. 1 :o w n Tenant: Suite #: Name: i_e,\DeCCa . B er Phone: U5 I- Lo33 " `1 1 1 Address / City / Zip: 3_q9_i__Aat kilnkikal Name: $ p Once s_Ik� License #: QJ 120CI M'tv__551.aa Address:12i\3 ()an 4 �1 City: State: , v Zip: 5531195531191�� ('y Phone: "l3a -41-15-4W Contactae_ 1411 Email: New X_ Replacement __ Repair Rebuild ___ Modify Space ___ Work in R.O.W. Description of work: RESIDENTIAL ' Water Heater ____ Lawn Irrigation (___ RPZ / __ PVB) ____ Septic System New Abandonment __ Water Softener Add Plumbing Fixtures (__ Main / _ Lower Level) Water Turnaround RESIDENTIAL FEES: $60.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) $60.00 Lawn Irrigation (includes $5.00 State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge) *Water Turnaround (add $189.00 if a 5/8" meter is required) $105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) TOTAL FEES $ LFO. 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.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. EKt Applicant's Printed licant's Signature C!ty of Eapll 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Permit#: I 153 �js� Permit Fee: (CAO Date Received: %- ?)-13 Staff: 2013 RESIDENTIALcTBUILDING PERMIT APPLICATION Date: / q /c3/?/3 Site Address: g 1 eq /3'f 1Ot-tilf t %f4j Unit #: Resident/ Owner Name: , Y PLJ °L /Ok Lki ! Dt't- AIS Phone: Address / City / Zip: Applicant is: Owner X Contractor Type of Work Description of work: ,400 f--7-1-JC- i46i� k ' ("Jr-- Construction Cost: Multi -Family (Yes / No ) Contractor �Building: `- Company: /9 ? -4- , rt -A ---k) CA -64g- Contact:Atmte 60AIJet-it Address: ? 1 7 v - ' cne_r-Cr - City: Edti--Z r- A (C State: /t -r/-' Zip: 5-5-1/0 Phone: 76 c y 2© ' 3i 6 ? License #: ,6 - 6:61 07 0 Lead Certificate #: S 6C 4'C4a.-1 If the project is exempt 8 t&...4-7"--- from lead certification, please explain why: (see Page 3 for additional information) /4-r-Tre- /7 7 8 ((7 96 -L6' 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 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 before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.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 autho zed by a building permit issued in accordance with the Minnesota State Buildin• .de must be completed within 180 days of per .' s;zaiice f g Applican ' " 'nted Name Applicant' =ignature Page 1 of 3 City of Eapn 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 r Use BLUE or BLACK Ink For Office Use Permit #: O 'e / �I Permit Fee: ! 4 . a.51 Date Received: (p -16- /� Staff: 2014 RESIDENTIAL GBUILDING PERMIT APPLICATION Date: Site Address: 3 / l Name: Resident/ Owner Address / City / Zip: 3 9 y7 r� wit Applicant is: Owner ,1 Contractor W� Phone: Unit #: Type of Work Description of work: ke sae w�`nCly�-S Construction Cost: GGC' Contractor Multi -Family Building: (Yes / No ) Company: Au/',21n E:J Ie Contact: .4yk IYf,,cel Address: ,R17 3 J9 City: 24/A, J & ' Lac_ State: / 11/7Zip: ST 7TL Phone: /2 `W/G 3Y ?EmaiI: License #: G e' , 2' 2 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: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information maybe 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 before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.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��1 Chi Applicant's Printed Na x Applican s Signature Page 1 of 3 City of Eagan PERMIT 4111' CityofEaan Permit Type: Mechanical Permit Number: EA135274 Date Issued: 03/01/2016 Permit Category: ePermit Site Address: 3991 Fawn Way Lot: 1 Block: 02 Addition: Deerwood Townhomes 2nd PID: 10-20201-02-010 Use: Description: Sub Type: Residential Work Type: Replace Description: Furnace & Air Conditioner Comments: Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Fee Summary: ME - Permit Fee (Replacements) $59.00 0801.4088 Surcharge -Fixed $1.00 9001.2195 Total: $60.00 Contractor: Standard Heating & Air Conditioning 130 Plymouth Ave. N Minneapolis MN 55411 (612) 824-2656 - Applicant - Owner: Rebecca L Boyer 3991 Fawn Way Eagan MN 55122 (651) 683-9171 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. Applicant/Permitee: Signature Issued By: Signature