1908 Southpointe Ter rF
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Cit of a �Il � p���� � �`��� ;
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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
YP ���k� '
� � � 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)
�[-�la5 �1..)�¢� �a/Lr PoS, / }y �
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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Applican�'s priM�ad Name Appllaant's SIQna�
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�r,• f ; Pem,it#: (� �
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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 —
YP�:..
� 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
Use BLUE or BLACK Ink
City of
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• For Office Use/
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Permit#: 'Permit Fee: 0
3830 Pilot Knob Road
Eagan MN:55122 Date Received:
Phone: (651) 675-5675
Fax (651 - 94 L Staff:
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' 2017 SIDENTIIA�L PLUMBING PERMITAPPLICATION
Date: l U f �'� Site Address: 16101 C D1 ���./v ""ecu '' /'' /
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Tenant: 0 1 47/V)-- _, Suite#•.
Name: Y6 ac v-- �–(
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1 9 Iv,„.1.4 o Phone:one:
, r "' Address 1 City/Zip: 6 i ,, Vl1 i
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Y �,�:� Name: 1 W� ( ��� ./(--3C L. r." ----)
��License#:
af,46 i.•ra - Address: V l �� \ �� Cit ICY \ (C/I U 141 -5-
„wig, .trine ,, 6 ,,,eta ` y4tt�11� ._ tyt e f t State: Y 1 , Zip: 3f l 05 '1` �� 1���`l. (
a, 1,4 ,1�144. �jnyn� +nye", n,/� Phone:
L-,,,4,4,„1:1,40,11,,
k�s N1liti iCt t 7i t ;' Uf 1 I , 1 \ ��e/vv2 �o' a I �/�e 61
, 1;fiir til;a} Contact: Email: Lam... C�lI � ��1 + -
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—New —Replacement Repair —Rebuild Modify Space _Work in R.O.W.
„,:f,;,'4.-4,4045,.
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, 4n.AK !}�c ;E, ii�s�;s, Descriptlon of work:
moit 'si ,`.- ,dii { 5.,,,tx • RESIDENTIAL
tVI
;1 • :1i' �. _Water Heater
., Sc3 'G 'i i' ,I+AIR
1i tS f tiefi 1 ,,,+, Water Softener
r�,(( SAtA Lawn Irrigation( RPZ/ PVB)
401 , i eCi
f;; ! t, Septic System _Add Plumbing Fixtures ( Main/_Lower Level)
' e'1)1 New _Water Turnaround
Sic:fid,,- ��1 —
.',,,;;,4.4;fA; =lltILI V4,' r.4,t,( —Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater,Water Softener, or Water Heater and Softener(includes State Surcharge)
$60.00 Lawn Irrigation(includes State Surcharge)
$60,00 Add Plumbing Fixtures, Septic System Abandonment,Water Turnaround*(includes State Surcharge)
'Water Turnaround(add $280.00 If a 3/4”meter is required)
$115.00 Septic System New(Includes County fee and State Surcharge)
TOTAL FEES $
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.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 ich requires review and approval of plans.
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Appli n Printed Name \ Appl, ant's Signature
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PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA156352
Date Issued:06/26/2019
Permit Category:ePermit
Site Address: 1908 Southpointe Ter
Lot:045 Block: 03 Addition: Sun Cliff 3rd
PID:10-72977-03-045
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.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
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 -
Karen S Rose
1908 Southpointe Ter
Eagan MN 55122--228
Genz Ryan Plumbing & Heating
2200 West Highway 13
Burnsville MN 55337
(952) 767-1000
Applicant/Permitee: Signature Issued By: Signature