3741 Burgundy Dr
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Id Use BLUE or BLACK Ink
For Office Use I
Permit 3 ~ I
City of Ea Rd~ ~ l
Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:' - ;
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff:
I
20213 RESIDENTIAL ?BUILDING PERMIT APPLICATION
Dater cJ Site Address: - 3 J
7 `7 - 37 VI &zr - Unit
i Name: Phone:
Resident/
Owner Address / City / Zip:3731-373 9 -3-74// t9ci u~io% ,di
Applicant is: Owner Contractor
I Description of work: ,
Type of Work
Construction Cost: Multi-Family Building: (Yesx / No
Company: U001e.: ~cs!/~! /sl~JieG Contact:
Contractor Address:3/00 su,0711ne-r 5✓ ~J City: ~d ~.S`' - 01
State: M/) Zip: -s•$"~/~3 Phone: _ Z/.? -13 00- 9460
License Be- ;2 6-.2a VC) Lead Certificate °-~37 9/2 V j
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
I
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:
i
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 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.oopherstateonecall.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.
x
Applicant's Printed Name Applica s igmature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA163517
Date Issued:09/03/2020
Permit Category:ePermit
Site Address: 3741 Burgundy Dr
Lot:3 Block: 05 Addition: Seneca Hills
PID:10-67125-05-030
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, Mark Anderson at (952)
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 -
Jarrod M Augustson
3741 Burgundy Dr
Eagan MN 55122
Bob Boldt Hvac
4310 Trenton Tr
Eagan MN 55123
(651) 454-7760
Applicant/Permitee: Signature Issued By: Signature