Loading...
1259 Timbershore LaneJul 09 12 10:50a Gates General Contractors l b. -A_ City of Eakall 3830 Pilot Knob MN 55122 C/ iV yr aill ' Road Phone: (651) 675-5675 Fax: (651) 675-5694 7634387710 p.1 ••• Use BLUE or SLACK Ink For Mee Use Permit Permit Fee: Date Received: Staff: 3 a-- 2012 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 76 07( Site Address: /Z 5 / • /76 7314644440-4,- 1-1/4/ Unit #: l/ Name: / %A'? oke-444art..1.— Al Phone: G fz° 2 7 f //7a. RESIDENT/ OWNER ; Address/ City / Zip: 7. d . 60K 2 " , 0 4 / e e.:41-7 niV PV1 ei./ 5 S - 7 2- / I. . . Applicant is: Owner 4 " ---- Contractor : • • -,..••.. • . . TYPE OF WORK Description of work: e 0--/t- /72 c_ Construction Cost: 9' ) 5 0 ? Multi-Family Building: (Yes G Company: L., 4 CV esVC4 ,c4r/ezottex5 ontact: . >Aft.4/0- c.--- CONTRACTOR .i Address: !-b V .7 .13 v 11-7 Z-nd 4/ yoo-Scly: , p/ 7 111--* c/Ver l State: /44."/ Zip: 5 VI Phone: 6 72 -'-' 77- 3 3 yi- License #: c 7 3 Lead Certificate it: N r 57 z- 55 / If the project is exempt from lead certification, please explain why: (see Page 3 for additional infomiation) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the las112 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. iwww.00pherstatepnecall.orp I 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 4 i------- Applicants Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA161673 Date Issued:06/08/2020 Permit Category:ePermit Site Address: 1259 Timbershore Lane Lot:2 Block: 04 Addition: Timbershore 3rd PID:10-76502-04-020 Use: Description: Sub Type:Residential Work Type:Replace Description: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 $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 - Matthew R Regis 1259 Timbershore Lane Eagan MN 55123 Haley Comfort Systems 4320 Hwy 52 N West Frontage Rd Rochester MN 55901 (507) 281-0138 Applicant/Permitee: Signature Issued By: Signature