3246 Alden Pond LaneSEWER & WATER' row
ail( OF EA1
''ilot'Knob Rd.
.P.O.Box 21199
Eagan,'MN 55121
PERMTDATE
WATER PERMIT #
METER #'
READER # �.
iPIETER SIZE
ISSUE DATE
SITE ADDRESS 324 .1144,s91a • e i NNT F EQUE Ti
LOT ..I QBLOCK C/SUB
APPLICANT: Rosewood' Construction, c. EW R 1 R , TAPS
1711 W Ounty Rd :: $ '
ADDRESS: ND' Roaeva' 11a �5 1I3 . , -Y-
TY, STATE,., bo1SZs4 ZIP t, /NE1iV
EXlSTIP
PLUMBER: PutJor°mechanical
ADDRESS. 1O6SO Highway152 3 ACBE G♦ LY, H CFTC
Mapl Craye, mN 5536 EAGAN
CITY, STATE`, zip
4614E' - _-11
2220 Lianited'Partoorehip
1711 W. COunty RRC B.
Reseti11e, MNZiP 1551.1
City of Eaan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee: [ /
Date Received:
Staff:
2016 MECHANICAL PERMIT APPLICATION
❑ Please submit two (2) sets of plans with all commercial applications.
Date:
i `) 6 Site Address: 3 2114 , -' \ ,
1lneTh
Tenant: / L r) e n � nr3 �Uw n )(•-•,(.5 ?vs_ `7
Suite #:
Name: e .-\ Rt) r1 C) .S Phone: 6 5 1 l-\ S Z- 6$ 0 9
Address / City / Zip: 3 21-i 6 h \ E - 7 O C�
Name:."R--,o S f CNN i-� trANN -,5 v Ai! License #:
State: n Zip:
Contact: n " �.
Phone:
Email: ()LiN - iLt)\ncc No A- 4 C4:3
New NcReplacement
Description of work:
Additional Alteration Demolition
Z1.00
CL-rraLiiki 3?- Z- -U�
RESIDENTIAL
Furnace
X Air Conditioner
Air Exchanger
Heat Pump
Other
al eq .s required to be screened by City'
information on i7tti =ecredf tt thods.
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 State Surcharge
$100.00 Residential New, includes State Surcharge
=$ 60
TOTAL FEE
COMMERCIAL FEES
$60.00 Permit Fee Minimum
$75.00 Underground tank installation/remoial, includes State Surcharge
Surcharge = Contract Value x $0.0005
If the project valuation is over $1 million, please call for Surcharge
Contract Value $ x .01
=$
_$
=$
Permit Fee
Surcharge
TOTAL FEE
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with t
Eagan; that 1 understand this is not a permit, but only an application for a permit, and work is yrbt`tp start without p
with the approved plan in the case of work which requires a review and approval of plans.
x \/c!.c.^
Applicant's Printed Name
x
inances and codes of the City of
that the work will be in accordance
Applicant
gnature