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3484 Greenwood Ct SAug 1 2012 12 36P Sela Accounting No 1661 P. 4 City of Eaean 3830 Pilot Knob Road Eagan MN 55122 Phone; (651) 675-5675 Fax: (651) 676-5694 Use BLUE or BLACK Ink For Office Use/y Permit*: �,-) Permit Fee: * 6 (,) Date Received: Staff: 2012 RESIDENTIAL BUILDING PERMIT APPLICATION Date: I /!1 Site Address: 3y 7$, 60 3N$2.-134Yy 6reer>;tabbci Ci-. S Untt#; -4 J RESIDENT / OWNER Name: 5uYYt'�/ N-c\l n��i C( CG Phone: ()S -?3l1-3$ / J e l\\L' Ca ;-},CN r Address / City/Zip: Lill ra- L-k.'hi (,Jt's+ Par-Lca y g;c\' n c)“,l,r\ ,rnY1 5 5 ',73I)1-1 Applicant is: Owner Contractor TYPE OF WORK Description of work: re (t Construction Cost: 1 chi 091 , DO Multl-Family Building: (Yes X / No, ) CONTRACTOR Com an nC,U-7 VI k Ke tVY'I t✓>� ���4 i : Company: &Ia., d I Contact: k. n Address: LU UCU t,XCr-A S► O t'' t61 V CL J City: S , LULR IIS r -k_ • State: Min Zip: S 5'-I 1 (.0 Phone: CII cJ L— i (`J - D- License #: __(12. VD) V 5_±(.2_ Lead certificate #: AfA r •-- a J 03 ii — 1 If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) In the last 12 months, Yes If COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING has the City of Eagan Issued a permit for a similar plan based on a master plan? yes, date and address of master plan: ^No Licensed Plumber: Phone: Mechanical Contractor: Sewer & Water Contractor: Phone; Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of 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. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call Ale hours before you Intend to dig to receive locates of underground utIlllles. www.00pherstateonecall.orq 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 he completed within 180 days of permit Issuance. rkhr�l�r x Applicant's Printed Name Applicant's Signature y j Page 1of3 TC Jul 15 2013 2:36PM BRUCKMUELLER PLUMBING INC 6516882160 *City o[Eke! 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 page 1 Use BLUE or BLACK Ink For Office Use Permit #: Permit Fee: Date Received: Staff: -1(7(3 INFLOW & INFILTRATION PERMIT APPLICATION V Plumbing 1 Sewer & Water Site Address: s Lj / V f"'ctr wood Co(A-1-1- 5O (---1-1-1 Date: "1- / 5-- / 8 Tenant: Suite #: tak Name: it km As 5ee'CC. Phone: CAS 2- -02- O /7 Address/City/Zip: 3'1(/Cr' r'eef-xi)eve/ Cc L(iSOL1M,kagan5S7 Name: andt 'iceirt a + - MT PICA in b _roe. License #: 0 621 S i- 1- Fm Address: ?9R:/JL41/'1( City: 1.4::a9a State: Mil) Zip: 561 a3 Phone: 65 7- 6.5 61. a Ce q Co Contact: trj-Lai6 Email: hrucktevieilerel rn!ari yc1. corn PLUMBING (Within the building envelope) 47 -Sump Pump Repair Other: SEWER 8 WATER (Outside the btAlding envelope) Repair Other: Description of work: AI^I'r19 �Ld r 1p PLt nip /h j ll9 1 L 2'i j Cede.. FEES $60.00 / Each (includes $5.00 State Surcharge) TOTAL FEE $ °O ,r `Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit III repair costs for reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors can be found by visiting wwW.citvofeaaan.comlinflow, or City Hall at 3830 Pilot Knob Rd. 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.gooherstateonecaliorg 1 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. x rt tckrv'u 4 Jer Applicant's Printed Name Ap cant's Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA165290 Date Issued:10/27/2020 Permit Category:ePermit Site Address: 3484 Greenwood Ct S Lot:2 Block: 09 Addition: Surrey Heights 1st PID:10-73000-09-020 Use: 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675-5675 www.ci.eagan.mn.us Description: Sub Type:Residential Work Type:Replace Description:Furnace Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088 Surcharge-Fixed $1.00 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 - Alemtsehay Assefa 3484 Greenwood Ct S Eagan MN 55122 Home Energy Center 2415 Annapolis Lane N #170 Plymouth MN 55441 (763) 476-1990 Applicant/Permitee: Signature Issued By: Signature