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4536 Mallard Tr SRESIDENT / OWNER Name: le e12 / Phone: `J /'- Address / City / Zip? cam 3 b • - 7i rkifi6_ i J ' P 7 / CONTRACTOR Name: C I� ©A" , 4VR 1 1` . L'C License #: Address: 6 A14/C„.< Li✓.: -,O Cl City: /i14 f State: YEN Zip: � /c2 &1 Phone: Contact: Email: TYPE OF WORK New X Replacement Additional Alteration Demolition Description of work: /V6-3 j cic,- ... NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City Code. Please contact the Mechanical Inspector for information on permitted screening methods. PERMIT TYPE RESIDENTIAL Furnace COMMERCIAL New Construction Interior Improvement � A 1S Air Conditioner Install Piping Processed Air Exchanger Gas Exterior HVAC Unit Heat Pump Under / Above ground Tank ( Install / Remove) Other ** When installing /removing tank(s), call for inspection by Fire Marshal and Plumbing Inspector RESIDENTIAL FEES: $55.00 Minimum Add - on or alteration to an existing unit (includes burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) L)° $5.00 State Surcharge) $ TOTAL FEE $95.00 Fire repair (replace COMMERCIAL FEES: $75.00 Underground tank $55.00 Minimum (includes installation /removal OR State Surcharge) $10,010, surcharge is $ 5.00 surcharge increases by $.50 for each $1,000 Permit Fee requires a $ 5.50 surcharge) Contract Value $ x 1% = $ Permit Fee - If the Permit Fee is less than Fee = $ Surcharge - If the Permit Fee is > $10,010, (i.e. a $10,010 - $11,010 Permit = $ TOTAL FEE City of Eagan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 FOR OFFICE USE .MR App icant's Printed Name Use BLUE or BLACK Ink Permit #: Permit Fee: 1 j7 ^ �/LJ 2011 MECHANICAL PERMIT APPLICATION Site Add ess:ASY„a ,, J / ` y / / Date Received: /' Id-11 Staff: Suite #: 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 •ermit; that the work wit be in accordance with the approved plan in the case of work which requires a review and approval of ^ ns y: Date: Required Inspections: Under Ground Rough In Air Test Gas Service Test In -floor Heat Final Exterior HVAC Screening lnspection SEWER & WATER PERMIT OFFICE USE ONLY CITY OF EAGAN METER # PERMIT DATE 07/00/90 383E Pitt Knob Rd . t WATER P ERMIT # 11512 Eagan,; MN 55122 -1897 METBI SIZE B.P. RECEIPT# C 8723 • ISSUE DATE B.P. RECEIPT DATE 01/06/90 �$ PRV _BOOSTER PUMP srrE RES 4536' Sou th mail l a r d Trail PERMIT REQUESTED LO � 31-001 C SEC/SUB Thomas Lake Woods APPLICANT: Thomas Lake .�e1opten SE W E R W TAPS ADDRESS: 6648 Rustic Road S , ' cOMMIIND RESIDENTIAL CITY STATE . 1 r i o. Lake, M N ZIP 55372 i =PHO 44 r N — EXISTING PLUMBER: Genz -Ryan Pluml4 ng & Heating ADDRESS: 14745 'South Robert Trail TO COMPtiTH CITY OF CLTY , STATE Rosemount;, N ZIP. 55068. ; .. ORDI N '2 �: n PHONE 423 -1144 o, �:. OWNER Thomas Lake ileyel QpPn t , Ltd. f ADDRESS: . 6648 Rustic Road. S. E. tN M ETIER IS4TUEA crrr, STATE Prior Lake , MN _ ZIP 55372 - .‘e. - • . < fi . DAB PIKICESSING. M fielPiER PERNOTS, CONTACT ENGINE RING DEPT. ' AICIPLIALSEMR WILL BE HO11F1I7D WHENL PER>IT ED. r----_-__-_.___ v• - I For Office Use I I Permit#:! Z11 City of Ea~a~ - I Permit Fee: 3830 Pilot Knob Road l 1 Eagan MN 55122 Date Received: -9 1 Phone: (651) 675-5675 1 Fax: (651) 675-5694 j Staff: I 1 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Ad/dress: l Unit Name: '7 3 At 3 q, rr, IWPhone: Resident/ Owner Address / City / Zip: r1iL Applicant is: Owner Contractor Type of Work Description of work: roo Construction Cost: Multi-Family Building: (Yes No ) Zvi J Company: / 11 ~Contact: ~a ~~d ? ~~a1 Contractor Address: v~ 4` ity: Lc~j~Lf State: Zip: 3 Phone: al / 6 3 oe License SC 6 J 6 3'~;- 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: i Sewer & Water Contractor:___ Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of M 1 the information may be classified as non-public if you provide specific reasons that would permit the City to I 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 di to receive locates of underground utilities. ~ 9 wvsN.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 authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. x nce. l~ d C k60 x~ Applicant's Printed Name Applicant's Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA167597 Date Issued:03/23/2021 Permit Category:ePermit Site Address: 4536 Mallard Tr S Lot:18 Block: 03 Addition: Thomas Lake Woods PID:10-76100-03-180 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 - Patricia Marie Lewandowski 4536 Mallard Trl S Eagan MN 55122 (651) 216-9254 Lindus Construction 879 Hwy 63 Baldwin WI 54002 (715) 684-4647 Applicant/Permitee: Signature Issued By: Signature