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