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3175 Alden Pond Lane SeiVERkik IN 'PER OFRcE 01v.Y OF E AN KETER # ^ * PERMIT Pilot 1 GnIP # LATER E # 7 MN 55422-1897 A kER S l. RECEIP' ", c '1; 3StfE DATE . B.P...REcEIP'FIDATE 71 i 8' 89 ItOOSTER fttitO SITE E 31 Are Con T.: TAPS APPLICANT t ;t4 ; ai RESi3. . 4 3 fll , . Cozint ' C C/IND t "'l VI driA , STATE eY12190 f X1A . 5 5 3 NOW 4532 254t exit. T F W MBE1:I: I` Mcgpi&icai e >. ,. 1 j t} 15; 1 +E COMPL' YI m CR'Y, STATE , k" r : MW tp , `56 N NC -OWN R 2 . te4 f R©o B. i�liEN � _ 1 • :UX ,� =Ml .� :55/13 CITY; STATE -,:.. t Oa : � • .• > z rUn a Use BLUE or BLACK Ink �------- --- --, � For Office Use� �� I Cit of�� a� � � � y � � Permit#: � � � � ; 3830 Pilot Knob Road � Permit Fee: � Eagan MN 55122 ��(�����(,� I � Phone:(651)675-5675 � Date Received: � Fax:(651)675-5694 � I ��c o r 2015 � Staff: � I ______J 2015 MECHANICAL PERMIT APPLICATION ❑ Please submit two(2)sets of plans with all commercial applications. Date: � 2_._s ?j-1� Site Address: ��� �'J �`t� r� � r, �a n �: ��.c. Tenant: �� r) c � � n � � � j G �.�.i n�ca^�,�5 Suite#: Name: .�4-� �) �� � �� �S � n�,.n.s°���� Phone: �S( - �5 2- b�o� ResidentiOvrm�r p.s ' Address/City/Zip: � tZ S ,74�� \v� � r�� ��L� Name: �5�1�-�"E��.,� ,"'��-�c_,'���4� ���r License#: �— �: Address: r�° �� �L. r--1 \ �� ��t - sv,�c/}'City: �� n n e.a._Pr�� �S ���O#t#�'r�tQ�`�" � °' State:_ '�� Zip: 5��h 7 Phone: � 1'Z- Z 2�-t - l��? Contact: �r� r�- `1-- Email: New Y� Replacement Additional Alteration Demolition �fiype�of Work � Description of work: Eo.-c�-� ���� � � � -:hK?'FE:12oaf ri�oun`t�id.anc��e�`���ntetl.m�an�ga���`uipr�et��t � ���ti���t 1�C�`y; C+r�tle: Pie�ase�ontsct the,��t�al trq�pe�tor for`ir�#�srm�t�c►r�Voci , r�irii����re�r��rt�;�i�i�t�#� RESIDENTIAL COMMERCIAL �Fumace New Construction _Interior Improvement ���•�•�,� _Air Conditioner _Install Piping _Processed Air Exchanger Gas Exterior HVAC Unit � �? � , _Heat Pump Under/Above ground Tank �install/_Remove) p� Other � RESIDENT/AL FEES� ' $60.00 Minimum Add or alteration to an existing unit, includes State Surcharge �p $100.00 Residential New, includes State Surcharge =$ �d TOTAL FEE COMMERCIAL FEES Contract Value$ x.01 $60.00 Permit Fee Minimum $70.00 Underground tank installation/removal =$ Permit Fee Surcharge=Contract Value x$0.0005 -$ Surcharge If the project valuation is over$1 million, please call for Surcharge =$ TOTAL FEE I hereby acknowledge that this information is complete and accurate; that the work will be ' con ormance wit the rd' a es 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 to s art without a er it; a he work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. x l 1e�1��n �C��'�c(' x ApplicanYs Printed Name Applicant's ignature �TV���f�V��SG ': '. , ., - 3.� �� � ..fr'.,,✓ �s,� k-�,..� ,; ` ; - ,� ,� �' v �r,. . ' i x � s:,,✓�"�" - ', . " `. ' _ as � . ,L�,�. i"��* :3y .� b�.s ,[-t,5�=„3s S.:` R�quFred-inspec#�an�: , �� ; . Review�d$y ��,*���.�,�,�,�T� �� Underground 'y Rough tn ;��„A�r�"u�,;;,_�;.��s��irice T�st t�'�`r"H�at ��:����fi�a�,�_;,�,�MVA���riirig; . ;,,