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3992 Fawn Way
RESIDENT / OWNER Name: Phone: Address / City / Zip: 3) 9 ® Auwc./ 4(-) A/ Z„49A 557 2 Z Applicant is: Owner Contractor T y-i ( (Ic) TYPE OF WORK , Description of work: iRr gbqc- Construction Cost: l 2 b o 6 Multi- Family Building: (Yes / No ) CONTRACTOR Company:41Ei A) E.Act t+. 4'w 1-rOJ Contact: V t.)€ Ro :`iYtE3 Address: /754 An Lo 04 0te. E City: RCS State: &) Zip: 55 + Phone: 7 " Li 2_6 3 /o °7 License #: Q©/ 5” / 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. City of Eagan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 x Applicant's Printed Name 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Use BLUE or BLACK Ink Permit Fee: as -Co Date Received: Staff: 6- I Date: Site Address: Unit #: 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, - a. 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 Page 1 of 3 Use BLUE or BLACK Ink r I For Office Use I I I Permit City of Ea /-,-"A Ed Permit Fee: VIP I 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: 3'i 1 Phone: (651) 675-5675 I ,n 1 Fax: (651) 675-5694 I Staff: 66 1 I I 2`013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: ! Gt f3 Unit ~ WCOQ /Ow.~1t(~zr~t~ I*S-S0 -141~Phone: Name: Resident/ Owner Address / City / Zip: Applicant is: Owner Contractor Type of Work Description of work: _ )eon r:Z~Jtr g-r_Pz_4C4"-t rAJT- " Construction Cost: Multi-Family Building: (Yes / No ) Company: Contact: Contractor Address: r -70 24S 5' 1~~ City: State: /tl/v Zip: t 5_1/v Phone: -76,?, 1/ 2U % 6 7 License /C g l o7o Lead Certificate S 97C /t_- 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 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.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 ized b a building permit issued in accordance with the Minnesota State Buildin de must be completed within 180 days of per . s ance x x Applican ' nted Name Applicant' ignature Page 1 of 3 r Use BLUE or BLACK Ink r..________________� I For Office Use I � � Permit#: ��V � " / � City of ����� ; . . �� � . �.�; Permit Fee. 3830 Pilot Knob Road � �J /�' l J Eagan MN 55122 � Date Received: ��- Phone: (651)675-5675 � � Fax: (651) 675-5694 I Staff: � I I 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: ���� � w wn-� �� Unit#: Name: , �9 n 5��+ Phone: Resident/ Owner ' Adaress i c�ty�z�p: S l�a ��.�., 1�ou,� ': Applicant is: Owner Contractor Type of WoI'k ', Description of work: �e S�U�� r6 i�i nG�vwS Construction Cost: � ���GC� � Multi-Family Building: (Yes /No� Company: �n�c��?na ��+,�e Contact: ___,�y,� /-5t.,ee<' Address: �f 7� ��J� City: �,/h�� ��i' ��i� Contractor ' State: �'1/FOZip: ��� Phone: v� �jG�Jy��Email: License#: � ��C�� 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 may be classified as non-public if you provide specific reasons that woultl permif the City to conclude that the 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.qopherstateonecall.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 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 �/r'G�T ali� C�, � X � ApplicanYs Printed Na Applican s Signature Page 1 of 3 !" #$%&'()'*+*, -./$%'"&0-146/7$,+ -./$%'56/7-.189::;;: >*%-'!??6-@199AB=A<B9C -./$%'#*%-+(.&1--./$% D$%-'8@@.-??1'':FF<''G*K,'S*&'' O"#$% &&25())**+ &&1--@S)&;S+HF-8&5+) /01 '235252'32532O2& 78- >-?2.$0%$(,1 ,9:&;.<- =-8*)-+*># ?@%&;.<- =-<#>$- 1-8$@*<*+ ?>-@&\]->-@ K--@&,*^-K--@&;.<-K>+9T>$9@-@,-@*>#&Y9F:-@=-F-&Y9F:-@*+-&,*^- /#->8-&$>##&"9*#)*+E&0+8<-$*+8&>&L6!'N&64!3!64!&&8$H-)9#-&>&T*+>#&*+8<-$*+Q #(//-,%?1 C>@:+&F+R*)-&)--$@8&>@-&@-G9*@-)&S*H*+&'2&T--&T&>##&8#--<*+E&@F&<-+*+E8&*+&@-8*)-+*>#&HF-8&LK*++-8>&,>-& "9*#)*+E&C)-NQ /&3&/-@F*&A--&L?,&B\\@&?\]NU!MQ22&2P2'QO2P4 G--'D6//*.&1 ,9@$H>@E-3A*R-)U'Q22&M22'Q5'M! "(%*41 H=BIBB' #(,%.*2%(.1JK,-.1 3&&(<<#*$>+&&3 CH>F<*+&/#9F:*+E`9+&,H-+E \[642&1))&=)QJ&d'22\[MM5&A>S+&?>. I>E>+&KY&&!!'5\[I>E>+&KY&&!!'55 L6!'N&\[6!3'\[O2L6!'N&5453M22M 0&H-@-:.&>$%+S#-)E-&H>&0&H>V-&@->)&H*8&><<#*$>*+&>+)&8>-&H>&H-&*+T@F>*+&*8&$@@-$&>+)&>E@--&&$F<#.&S*H&>##&><<#*$>:#-&,>-& T&K*++-8>&,>9-8&>+)&C*.&T&I>E>+&W@)*+>+$-8Q (<<#*$>+\\/-@F*-- &,*E+>9@-0889-)&". &,*E+>9@- PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA176280 Date Issued:05/10/2022 Permit Category:ePermit Site Address: 3992 Fawn Way Lot:4 Block: 02 Addition: Deerwood Townhomes 2nd PID:10-20201-02-040 Use: Description: Sub Type:Furnace & Air Conditioner Work Type:Replace Description: 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 - Michael J & Judith C Salkas 3992 Fawn Way Eagan MN 55122 (815) 342-1780 Apple Lake Heating & Air Conditioning 207 150th Street West Apple Valley MN 55124 (952) 431-4328 Applicant/Permitee: Signature Issued By: Signature