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PHONE: 47 -24 K � EXI G
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CITY STATt , OS Q 1144 21P { . _ N ORDINANCES
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Permit Fee: 5~}q pt~ I
3830 Pilot Knob Road I 1
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I _91~
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Fax: (651) 675-5694 I Staff:
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2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit
Resident/ Name: -Phone:
a
Owner Address / City / Zip: ~i 114 a/ j/ i, c,;
jaei
Applicant is: Owner A( Contractor
Type of Work Description of work: )Oc ro& 6-
Construction 3 000 r CIO Cost: ,
Multi-Family Family Building. (Yes / No )
Company: Contact: 'eU:~s F✓'c `U,C~
Contractor Address: jA,1 r 0~ ity: &;J4
State: I P Zip: G-S' 33 ) Phone: a/c ~ - 5 -U 63O&D
License 7c, 631639- Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
I
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 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:
1
Licensed Plumber: Phone:
I
Mechanical Contractor: Phone:
Sewer & Water Contractor: i
I _ _ Phone: ~
(-NOTE Plans and supp_orting _docum__ents _
_that_you submit_ are considered to be public information. Portions of A
I 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. i
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. www.gopherstateonecall.org
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.
xv x
Applicant's Printed Name Applicant's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA131138
Date Issued:06/03/2015
Permit Category:ePermit
Site Address: 1572 Mallard View
Lot:8 Block: 02 Addition: Thomas Lake Woods
PID:10-76100-02-080
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & 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)$55.00 0801.4088
Surcharge-Fixed $5.00 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 -
Darrell L Haines
1572 Mallard View
Eagan MN 55122
(651) 454-2484
Wenzel Heating & Air Conditioning
4145 Old Sibley Memorial Hwy
Eagan MN 55122
(651) 894-9898
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA139914
Date Issued:11/14/2016
Permit Category:ePermit
Site Address: 1572 Mallard View
Lot:8 Block: 02 Addition: Thomas Lake Woods
PID:10-76100-02-080
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:One Window/Door
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 500.00
Fee Summary:BL - Base Fee $500 $40.00 0801.4085
Surcharge - Based on Valuation $500 $0.50 9001.2195
$40.50 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 -
Darrell L Haines
1572 Mallard View
Eagan MN 55122
Champion Window Company Of Mpls
5100 HWY 169 N, #B
New Hope MN 55428
(763) 574-2054
Applicant/Permitee: Signature Issued By: Signature