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8830 Pllot Knob Road � �
Ea{�an MAN 55122 j Dsle Receiv�d: � I l / j
Phone:(851)679�8675 I �
Fax:(651)6755684 I � �
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2o�a RESIDENTIA� BUILDING P�RnniT AP���caTroN
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Oate: Sf�eAddrees:14i�,_�wi��?, zo,x�,xY Sau;,�/Po�.JT'E 7�2 Unit�:
I �' Name:��o A C 7' /�1�4 n.l�1��1'N E�U T .7"�3 C Phone:7G3 -s'43 �7��
� , Address/City/Zip: �5 d � �e.i4 �-^�2 /�t/ � � �oi.�E.� +ViK��
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. Applicant Is: Owner �Contractor
T �,;� .:..";�' Desarip�ion of wor�t� /�L'�.o✓z, e� Q ���f c E �i d�kJ co
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� � � Cohsbuction Cast��9 �� �" Multi-Family Bullding:(Yes x' I No�
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• Company: ��/ ���clt�oR /Y/�i,��. �� Contact �wv�9 1��2R�S
��a�7°� �aaress: �/os C�1 6v� S�. ��y; lhP�.S
�`'_. � Sqte: /�� Zip: .S�S`�� 9 Phone: �O�� �6�~ �o z�l3
' � : �icense#; �e �y/�s I l.�aa certificabe#_
If the project is exempt from lead certiflcatio�, please euplain whj/: (see Page 3 for additional information)
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COMPL�TE THIS AREA ONLY IF CONSYRUCTING A NEW BUILDING
In tAe laat�2 months,has the city of�agA�Issued a pennk for a��mflar plan based on a maater p1An?
�Yes �No If yes,date and address of masbar plan�
I.icensed Plumber. Phone:
Mechanical Contrs�ctor: Phone:
Sawa��VY�ber Contractor: Phono•
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CA�,L F.f�FOR�YOU bIG. Call Gophq Sbete pns Call at(661)45�.00pZ for proteclion egalnst underground utlliry demsge_ CeM 48 twurs
befare you Intend to dig ta recelv�e lacatee of undetground utililies. �vw. op oherst�teon�q.c,�
I hergby acknowledge that Ihis in(pmtation is complate ana sopuratg;Met�he woAc will be in Contomtance with the adinanoes and codes of the Gty ol
F�gen; that 1 underbyqnd thig is nol a perntk, bu!oNy an appACBtion for a nermR,and wqrk ie not to stsrt wiThout a pertniN, Ihat thc worfc wiU be In�
soeo�dana.w�tn tho approv�d plan In rfte Caso oi work whIG1 nBqU1nES a�evi81N 811d epprpv9l C1 plans.
Exbedorworic aulhorf�sd by a building permit iSSUad In a�qrytance wfdl tNe Minnoso0s SEate BUlldl Code must bo oompl6ted witi�in 1$0
deys of pertnK Fssuanr,e,
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3830 Pilot Knob Road �''�h� F/� �!"!'�°'� I �
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� Eagan MN 55122 -�;.� � Date Reoei�red: I
Phone:(651)675�',675 �
Fax:(651 j 675�5694 � �' I
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2013 RESIDENTIAL BUILDING PERMIT APPLICATION
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Date: �� Si�Address:iSiy,��;�g, xu,xx,x 5�' Sov7-�Pe�.��~�' .7."�2� Unit#:
�. Name:��o f1 C T /y1,q n3�4��rit E v T .�"�C Phone:7�3 -s'9 3 - ��7 0
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bv�mer . ' aderess�c�y�z�p: 8 so a ��,a �--�,e Av ,� .� � p o E,..�
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�. APpiicant is: - Ov�mer �Contractor
T , �'IdV41�c. Description of work: T£� �F-�= � (Z E- �F —
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� Construction Cost��� 7��.� Multi-Family Building:(Yes � /No�
. .. Company: �E 1 £,��rE.2•��e /�'17i,.s�. �� Corrtact ��av�� �`'��5
Cc�ai�r�::;" add�ss: �os t� 6�� S�. c;ty. �PL S.
. s��: �� zp: ssy�9 Phone: (a�z - �b�- �x v3
: � ,. ucer�ss#: �� .�YI�3/ Lead cerdficate#:
If the project is exempt from lead certification, please explain why: (see Page 3 for additionai i�ormation)
����s �J�Q� l��,�r Pos. i 5+7 �
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 morrths,has the City of Eagan�susd a pertnit for a similar pi3n based on a master plan?
_Yes _No If yes,date and address of master plan:
Liceosed Plumber. Phone:
Mechanical Contractcr. Phone•
Sewer�Water Contractor. Pho�:
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�ALL BEFOR�YOiI DIG. Ca��Copher state o�Ca�i at(651)dsa�o002 for protedion against underground uduty damage. Cau 48 hours
b�Y��d to d'ig co r+eCeive bCates of undencjround uGT�tes. www.002h_erstateonequ.orv
I herebY�thet tlus infortnation is oanplete arld a�rate;that the work will be in confomianoe wifh the adinances and codes of ihe Cily of
Eagan; that I un�and this is not a Cerrnit.but only an appGc�tion for a pein►it.and work is not to start�a aertnir.that the wcric wiu be in
aoee�danc:•w:�►a tM aPP`ovod Wan Ut the cese af woMC whNY7 I��WfCS 8(@ViBVH 8fW 8�(NOV81 OT p18�i5.
Exterior work aulhorized by a buildln9 Pennit issued in accordance with tha Minn�Stabe Butic6 Code must be rompieted wid�in 180
days of Permit�u8�.
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Applicant"s Printed Name APPlicanCa Signaturo
Page 1 of S
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA178694
Date Issued:08/30/2022
Permit Category:ePermit
Site Address: 1904 Southpointe Ter
Lot:037 Block: 03 Addition: Sun Cliff 3rd
PID:10-72977-03-037
Use:
Description:
Sub Type:Furnace & Air Conditioner
Work Type:Replace
Description:
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, Pete DeGrood at (507)
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
This permit shall be null and void if work does not start within 180 days of issuance, or if work is suspended for 180 days or more after
started.
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 -
Jm Ian Schliecker
1904 Southpointe Ter
Eagan MN 55122
Pronto Heating & Air Conditioning
7415 Cahill Rd
Edina MN 55439
(952) 835-7777
Applicant/Permitee: Signature Issued By: Signature