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3157 Alden Pond LaneSEWER & WATER PERM' CITY OF EAGAN 3830 PiInt krIob Rd. Eagan. MN 55122-1897 OFFIE:E Wie ONLY PERMIT DATE 8 / 1:/829 WATERPERMIT # 10792 $12E B.P. RECEIPT # C 2995 ►ATE 8.P. RECEIPTDATE 7(14189 _PRS/ BOOSTER PUMP SITE ADDRESS " 3157 Aiden• COT 8 BLOCK 2 REC/SUB APPLICANT: ?Gse road CoDatrgct ADDRESS' 1711 W. C9unty Rola CITY, STATE ; Roseville `liN •Y .ZII 551, PHONE 631-3254 Majar 'lifochanirs ," Tnr- A0640. gigue»Y Maple Grove . MN 414-468Q, 410/`. C!ty of Pio 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Ur 11 (1 Permit #: Permit Fee: Y!O. 04 Date Received: 12r/Ia/i7 Staff: 2013 MECHANICAL PERMIT APPLICATION ❑ Please submit two (2) sets of plans with all commercial applicions. Date: r2--`' 1 ` 13 Site Address: 3 1 5 1 A Q c. n O^ U t� ^d- 1 r--, Tenant: A\ [Jtn o,. $ r O w.n (n "-.. S Suite #: Name: 1 Q n ?O e, , O (,) ,-. `�o_n^.c Phone: is S (• 7 `- 6' el Address/City/Zip: 3b 00 A i cl cn \. 0 d 1 c‘..,-,ccMt5S`T) Name: Std, r, k - \ 1 \e ' r , 4 A% r License #: Address: 1%iS F. Li Or 'S - Su`ic A City: M,knr,r r,,; G 1, S State: (ice- Zip: S 5101 Phone: 6 I Z '(2-14- 1 cici Contact: A c, ..,.z - Email: OL K.TJkne_c Qi ho (- cont New Replacement Additional Alteration Demolition Description of work: , • " 7 �T J RESIDENTIAL Fumace Air Conditioner Air Exchanger Heat Pump Other COMMERCIAL New Construction Interior Improvement Install Piping Processed Gas Exterior HVAC Unit Under/Above ground Tank (_ Install / _ Remove) RESIDENTIAL FEES $60.00 Minimum Add or alteration to an existing unit (includes $5.00 State Surcharge) $100.00 Residential New (includes $5.00 State Surcharge) COMMERCIAL FEES $55.00 Permit Fee Minimum $70.00 Underground tank installation/removal =s 60a1) TOTAL FEE Contract Value $ x .01 _$ *If contract value is LESS than $10,010, Surcharge = $5.00 $ *If contract value is GREATER than $10,010, Surcharge = Contract Value x $0.0005 **If the project valuation is over $1 million, please call for Surcharge = $ I hereby acknowledge that this information is complete and accurate; that the work will be it conformance Eagan; that I understand this is not a permit, but only an application for a permit, and workq n to start wio with the approved plan in the case of work which requires a review and approval of plans. x Applicant's Printed Name x App Permit Fee Surcharge* TOTAL FEE inances and codes of the City of that the work will be in accordance an Signa ure