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1758 Karis Way • 4 aL SERinCE 7 if.aoeir'Itoilt PERMIT tNO.' W't `: DATE : ` ..H.- J4/1 = Aft unit. «""fly' se r ',,..rite '" !1crl Home* - 1.7 :ari ;;'ay L4 B1O R gec.iffe III Pkmiber: . Meter No.: connection . : 30 4. O p Size: Acme/fit Deposit: Mo.: p Fe 10.00 ',ti, too.' .4402.011 ..ittr Mie O y of sire.. Q apilipipoimik • Misc. Charges: 5(. . p p meter Total: By ®'k Dote Pte: Dote of Insp.: y cam® Irmo.: *Uob FERA�IIT � \ , - � ' k AN Ull DATE: _____ { A Zoning: T . o f U NQ nits: ice : Address: St Address : ..., .), Yar:is , lay L4 1 210 Fic .eclif f e III Plumber• (`ea- z n - a1. I M W N OM* MOIL * of s +aeti Chow 1 2 X) „ 'a . '' a Deposit: Permit Fee: - l O / C} n h -a B Mist rg ate ofl Imp ' :' Total. ` <;, ` 3 Qote Paid Use BLUE or BLACK Ink r________________� I For Office Use � • I Permit#: � � I I �,� City of �a�a� I Permit Fee: . � � 3830 Pilot Knob Road I I Eagan MN 55122 � Date Received: � Phone: (651)675-5675 I I Fax: (651)675-5694 i Staff: i 2015 RESIDENTIAL BUILDING PERMIT APPLICATION Date: � 1 "' �� Site Address: I ��ff /�`U al(k�'fs�+�'� �6�� y��� �Cr"f`� r Unit#: ,�;. � � �������� ���°" ���'��� �� Name:—!, ������� �I r�� Phone: � ��� � .; Res�de t/ ��� ��'��`� � � �-l�7 I �.l S� ��— a�r�'�t�, Owner �' Address/City/Zip: � � � � i#�� ����.�;, Applicant is: Owner Contractor ��� # ���:� �: ��� : ����� � �;», �� �.: Description of work: �i��� '�► � Type�of�Work�; ,� ��� ��., ,�F�� Construction Cost: � ( Q � �' Multi-Family Building: (Yes ( /No ) "�� � �' � . ��.��.��'� "F `� �° � � y� �;�'�� Company:__ �-tS i/'l 2iJL� t1Uy� Contact:�� �hrl t i'e °s _ � � �� � � ����� '. �� � y ���,� '�. ��Contractor��� Address: /�,�-r� � ��Q����� cit : ✓l�`P � � �� ��� �, � � �� q f _ ��' ; State:� � �3�31 Phone � �� Zip: �"`'�l�-��� / EmaiL•�Oh'�Ip h 6irs��l��lvov'Pl� �° l� -> � �• ' License#: ,r�[}( �b��P� 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: Phone: ' Mechanical Contractor: Phone: Sewer&Water Contractor: Phone: ��''NOTE P/ans antl su orfiri tlocui�i�ents�fhaf��ou subm f are cons►dered'tQ be��ub,�rc� fo `��`at�on orrtiQ�ns��o�_ � . . .� PP �ti.,,�'�.zara�,�,,,^7. €�#a�� �k,: ''`� ``,� "=�`��.�� "��.. 2�.,..','„� �r. � �, ��� ; '� '�.'�€ �...a3� _ �t�►e�nfor�mation may be c/�ssc ��d s€aor��p�b�Ir�G rf��yQU p��o�r�a/e sp���c� easo �th� woul erm�t t e�t .`#o ��`.��. ., ��.�4 ���'.�. .: �� - � ' � � �:, � .-S� ��r� R° ,.°'� b �: a� ^ �, � . . �,� .: _ ' . � � . �. �:.�on.clud�that�they.are:xtraale sec�ets�; �.���,, - 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 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 completed within 180 days of permit issuance. �, x �� ��'�`M x App' nt's Printed Name Appli ign e Page 1 of 3 PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA172700 Date Issued:10/12/2021 Permit Category:ePermit Site Address: 1758 Karis Way Lot:4 Block: 10 Addition: Ridgecliffe 3rd PID:10-63982-10-040 Use: Description: Sub Type:Residential Work Type:Replace Description:Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507) 210-0754. 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 - Treasurer-auditor % Document Processing 1590 Highway 55 Hastings MN 55033 Blue Ox Heating & Air Llc 5720 International Pkwy New Hope MN 55428 (612) 238-9709 Applicant/Permitee: Signature Issued By: Signature