3215 Alden Pond Lane &EWER & WATER PERMIT OFFICE 'USE ONLY ,
,CITY O` EAGAN N TEfR # . 1 RMIT DATE 8/11189
X330 Pilot t(noh Rd.
• C # tA,1TE R ' PERAArr # -4. t J 76U
HP
. °Eagan, MN 55122 -180`1
METER SIZE _ - 0 I?. RECEIPT # . `. -C 2730
.fi ISSUE DATE S.P. RECEIPT DATE. 6/29/89
PRV _. 1300ETMR PUMP -
SITE ADDRESS ..32. 11.ide.42 Fond y�e PER1il` REQUESTED
LOT 4 BLOCK CtStitt _ - - . ._
APPLICANT: Cpr truction. Inc. .
EWER TER ..TAPS '
ADDRESS' Z?Zl W. Couz'ztq B'144 . B — CON UIND ESIDEN TtAL
CITY STATE 1oaev lle. .lam j 551
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; . '�iONE �� 631. ' 32 ", 4 , ; ' . NEW t EXISTING
PLUMBER, l ,or k•,Iw n i ro 7 : 7i me .
ADDRESS: 7 064a t i or41,j 75 1 1 AGREE TO cCMIPLY W TH CITYOF
CITY, STATE M 2" GYPDve l J i ZIP 55369 ` EAf3AN ORDINANCES:
PHONE: 424
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OWNER: 2 7'..
,:.ADDRESS: 11 W - R 73 SIGNATURE WHEN MSTER
CrrY,STATERap,
o `v ZIP 4 35123
PHONE 61..6-8'
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C/l `'� ��U+�� ___ Use BLUE or BLACK Ink '
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t (�fj� �Q /� /��'v � Permit#: ���6 I
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3830 Pilot Knob Road � Permit Fee: � �
Eagan MN 55122 I �_�-^�_�� I
Phone:(651)675-5675 � Date Received: �
Fax:(651)675-5694 � �.`^ j
JUL 2 7 2015 � Staff:�l �
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2015 MECHANICAL PERMIT APPLICATION
❑ Please submit two(2)sets of pians with all commercial applications.
Date: � ` Z� '�� Site Address: � 21 � �� �Q n ��n ,�J Lo.� c,
Tenant: �� ��,� ��n G� � Suite#:
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x � ���� �� �; ��; �Fumace _New Construction _Interior improvement ��
X . �? . 6 �#2 r � .
������ � _Air Conditioner Install Piping Processed
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��'�r" ` � ,�. _Air Exchanger Gas Exterior HVAC Unit '
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�� Heat Pump _Under/Above ground Tank (_Install/_Remove)
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RESIDENTIAL FEES
$60.00 Minimum Add or alteration to an existing unit, includes State Surcharge f c��
$100.00 Residential New, includes State Surcharge =$ ' ', ip � TOTAL FEE
COMMERCIAL FEES Contract Value� x.01
$60.00 Permit Fee Minimum, includes State Surcharge
$70.00 Underground tank installation/removal =$ :" Permit Fee
*If contract value is GREATER than$2,010, 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 in coofo ance with t e or nanc s 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 ,�`sta without a p rmi ; hat t e work will be in accordance
with the approved plan in the ca e of work which requires a review and approval of plans. ,�
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Applicant's Printed Name Applicant S' nature
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