1301 Crestridge LaneRESIDENT /
OWNER
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Name: � � -lr / ��� / 'y!C%� Phone: G 5 ' �
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Address / City / Zip: / 9 , C Ye 5 r,-t )2- f, e G.. A (�-t %' 53 i 2
Applicant is: Owner ' CC;ontractor 4 itt 76. pr j 21/1 v.--
TYPE OF WORK
Description of work: (‘i-4" e(-- t k- /d�� /.O/
Construction Cost: 2 1 I t i) Multi- Family Building: (Yes'& / No )
CONTRACTOR
Company: /1/0/1A.1 o/ l,,1 - r L c2 / /a? n - 1 „° s ''G Contact: • r r %vz /14( �c--- t
Address: &72 1 Z , :2 / ' 4 c A- - - City: ` ; - //C &0/2
State: / 1 t` - Zip: -- 5 3 ( C Phone: 6/2 r/ Gl ✓ '~/
License #: p G 1 CI 4 ”( 73 Lead Certificate #:
If the project is exempt
from lead certification, please explain why: (see Page 3 for additional information)
In the last 12 months,
No 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:
_ Yes
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
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.
City of Eagan
Date:
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
x / Golf
Applicant's Printed Name
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
Site Address:
r
/Applicant's Signatur
Use BLUE or BLACK Ink
For Office Use
Permit #: / (c)
Permit Fee: J 7 17_.<
Date Received:
Staff:
Unit #:
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.
Page 1 of 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA132425
Date Issued:08/13/2015
Permit Category:ePermit
Site Address: 1301 Crestridge Lane
Lot:1 Block: 04 Addition: Hidden Oaks
PID:10-32750-04-010
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description: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)$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 -
Mary M Jensen
1301 Crestridge Lane
Eagan MN 55123
(651) 686-8357
Haley Comfort Systems
122 3rd St W
Hastings MN 55033
(651) 437-0338
Applicant/Permitee: Signature Issued By: Signature