4725 Sunne PtWATER; SCRRVIME PERMIT
Road PERMIT NO.:
M$ 55122 DATE: ;. t
r No. of Units
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Total:
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crrr,r VW EAG►iwt *EWER SERVIM PERMIT
97 5 Pilch X.ob ftp PERMIT NO.c
gegen, MN 55122 DATE
Zoning: No. of (nits:
Owner ^
Address:
Site Address:
Plumber: •
spot to wilgo irecity of gegen Connection Charge.
+mor. ' - Account Deposit;
Permit Fee -
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Surcharge:
Misc. Charges:
Total:
Date Paid:
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City of Ea�all
Date:
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
el en
)wner
Use BLUE or BLACK Ink
For Office Use
IIi1��
Permit #:
Permit Fee: W425
Date Received:
Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
3
Name:
Site Address: 91.2, ',y7Z3-friiow b W2219724' i f174 Unit #:
/zzz.z-rye
Phone:
Address / City / Zip:
Applicant is: Owner X Contractor
eofWo
Description of work:
re°
Construction Cost: f 2..O t! J J
Multi -Family Building: (Yes / No
ontractor
Company:
Address:
/3i0r 54 5t? 61 -
State: /1M-7 Zip: 175373 Phone:
License #:1,3,4 6Z: 1
Contact:
City: g4jse
6/2,10-- P67
Lead Certificate #:
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
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:
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
NOTE: Plans and supporting documents;that you submit are consideree
r,fr.
e information maybe classified as non public if you provide specific reasons,%
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 48 hours
before you intend to dig to receive locates of underground utilities. www.qopherstateonecall.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 be completed within 180
days of permit issuance.
x e;�44—
A I ant's1E
ppPrinted Narhe
x
Applicant's Signa
Page 1 of 3
City of Eta
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use r� � ���
Permit #:
Permit Fee: Qo
Date Received:
Staff:
L
2013 MECHANICAL PERMIT APPLICATION
❑ Please submititwo (2) sets of plans with all commercial applications. 'At
5 l L3 Site Address: Li 12.5 J w2 Po n �+
Tenant: Suite #:
Name: l
Phone:
..1
Address / City / Zip:
Name: 1 n • LOC)t4 `D%1 License #: IA21);3c
Address:` [OP 30 atilt kit City: 6 'ih-C
State: M IV Zip: 5S/3-1- Phone: ( p {2. 2-C/ 0 47
Contact: [ G b k -L Email: k ‘ j -CA 7I J 1'1 U-✓ 0 .11 Coo
New )tBeplacement Additional Alteration Demolition
Description of work: . AA amt.
apt
RESIDENTIAL
_Furnace
Air Conditioner
Air Exchanger
Heat Pump
Other
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 $5.00 State Surcharge)
$100.00 Residential New (includes $5.00 State Surcharge)
COMMERCIAL FEES
$55.00 Permit Fee Minimum
$70.00 Underground tank installation/removal
*If contract value is LESS than $10,010, Surcharge = $5.00
**If contract value is GREATER than $10,010, Surcharge = Contract Value x $0.0005
***If the project valuation is over $1 million, please call for Surcharge
_ $ TOTAL FEE
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 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 app oved plan in the case of work which requires a review and approval of plans.
x LIZ/
Applicant's Printed Name
x
Appl