4457 Cinnamon Ridge Cir :ATV cr EAGANN WAT kV k E Pa id
3830 Pilot Knob Road
P. 0. Box.21199 PERMIT NO.:
Eaaan, MN 55121 DATE:
Zoning: No. of Units:
Owner: _
Address:
Site Address:
Plumber:
Meter No.: Connection Charge:
Size: _ Account Deposit:
Reader No.• Permit Fee:
1 agree to comply with the City of Eagan Surcharge:
Ordinances. Misc. Charges:
Total:
By Date Paid:
Date of Insp.: /_ K-1 Insp.:
CITY OF EAGAN I SEWER SERVICE PERMIT
3830 PElof Knob Road
P. Q. Box 21199 PERMIT NO.:
Eagan, MN 55121
DATE: _._.
Zoning:
No. of Units:
Owner:
Address:
Site Address:
Plumber:
1 agree to comply with the City of Eagan Connection Charge:
Ordinances.
Account Deposit:
Permit Fee:
By Surcharge:
Misc. Charges:
Dote of Insp.:
Total:
I nsp.:
Date Paid:
Use BLUE or BLACK Ink
For Office Use p !
/00 ~y`~ I
City O .runa~11 j Permit 0
i ro !
I Permit Fee: 4a(J,
3830 Pilot Knob Road I
Eagan MN 55122 j Date Received:
I
Phone: (651) 675-5675 !
Fax: (651) 675-5694 Staff: /Y L.,
2012 MECHANICAL PERMIT APPLICATION
Date- Site Address: ~ ~ y r~nr~1 Lz2LL 1. 1 ,k
Tenant: 1 r Suite
RESIDENT / OWNER Name: IS C„ C'yt(i t r'~ 4 Phone: (0 S1 c~ Zs a -t~C13~~
Address / City / Zip: J'~ a
9URNSVILLE HEATING
Name: 1 -1 - 11_ License
V
CONTRACTOR Address: 0U:11G "2C City:
Burnsville, MN
State: Zip: Phone: X52.- (-Lb X
Contact: Email:
New Replacement Additional Alteration Demolition
TYPE OF WORK Description of work: LYIJ-~ A o jLf d1 & 00. Arai f1 (1 rha d 4-slb-1
NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City
Code. Please contact the Mechanical Inspector for information on permitted screening methods.
RESIDENTIAL COMMERCIAL
Furnace _ New Construction - Interior Improvement
PERMIT TYPE Air Conditioner Install Piping _ Processed
_ Air Exchanger _ Gas _ Exterior HVAC Unit
_ Heat Pump _ Under / Above ground Tank Install Remove)
Other Cam(! t X12,
RESIDENTIAL FEES:
$60.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge) /
$100.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) TOTAL FEE
COMMERCIAL FEES:
$75.00 Underground tank installation/removal (includes $5.00 State Surcharge) OR Contract Value $ x1%
$60.00 Minimum (includes State Surcharge) Permit Fee
- If the Permit Fee is less than $10,010, surcharge is $ 5.00
If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee = $ Surcharge
(i.e. a $10,010411,010 Permit Fee requires a$ 5.50 surcharge) TOTAL FEE
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.aooherstateonecall.ora
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 t approved plan in the case of work which requires a review and approval of plans.
x x
Applicant's Printed Name Applicant's Signature
FOR OFFICE USE
Required Inspections: Reviewed By: Date:
Underground Rough in Air Test Gas Service Test In-floor Heat Final HVAC Screening
Oct.18, 2013 9:02AM Crest Exteriors 651-463-8095 P. 29
Use BLUE or BLACK Ink
~ ^
ForOfflcaUse^^'wfi`rJ_` ~
I Permll l l 1
City of Eakan I
I Permit Fee; l
3630 Pilot Knob Road
Eagan MN 55122 I Date Received: j
Phone: (661) 675-5676 I 1
Fax: (661) 676-5694 t Staff I
1
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: I D- I -1 -1 ~ Site Address: "7 Unit
Name: f~Qy W La Phone:
~ Res tlenU~ ~ (^,n ~1 l -
- ' r%•" Address /City/Zip:_/95•-7 ' CI ~1 1C 1~J\ u ` C ~1
y' Applicant Is: `Owner V Contractor
Description of work: R~ r~~ln
O
Construction Cost: Multi-Family Building: (Yes / No
L ~
Company: .
I l ~WVN ~f X) l ( &"Contact
O r C t - Address: ity:
x '
State: Y111) Zip: G 1Z,
1 Phone: l 9 j 2-
BC_
4t A ' License Z~l? 2 v 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 leaued a permit for a similar plan based on a master plan?
__Yes ZNo If yes, date and address of master plan;
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
^OTE Plas~aritlsZ p o f oaf - os` m ;'a"° '
tl'fob lilic t inriford ir Vo`n ,m~ t/ons.of
CALL BEFORE YOU DIG. Call Gopher State One Call at (861) 464-0002 for protection against underground utl►py damage. Call 46 hours
before you Intend to dig to receive locales of underground utilities, www.gonherslateonec tl.oro
I hereby acknowledge that this Information is complete and accurate; (hat the work will be In confomtance with the ordinances and codes of the City of
Eagan; 111121 111 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 leaued In accordance with the Minnesota State Building Code must be completed within 180
days of permit Issuance.
X x
Applicant's Printed Name Appllcant'e Signature
Page 1 of 3
Use BLUE or BLACK Ink
For Office Use
j Permit I
City of EaEaR
I Permit Fee: OC5• 35 I
3830 Pilot Knob Road I
Eagan MN 55122 I Date Received:
I j
Phone: (651) 675-5675
Fax: (651) 675-5694 i Staff: 0103
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit
Name: . t Phone: 6~sf °
Resident/
Owner Address / City / Zip: 11-01/2
Applicant is: Owner Contractor
Description of work:. ILr
Type of Work
Construction Cost: Multi-Family Building: (Yes / No )
Company: . ~AR3S ~~$~~N S'& ttVo' contact: #34, 4 ,0o~ /I,;
Address: city: M.Olkj. l ~1 r
Contractor
3
State: Zip: f ' g0 Phone:
License ~ ? a 2- Lead Certificate //,4-7
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. Plans and supporting documents that you submit are considered to be public information. Portions of
the information maybe classified as non-public if you provide specific reasons that would permit the City to
conclude that the 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.gopherstateonecall.org
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
days of permit issuance.
Applicant's Printed Name App scan
Page 1 of 3