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4317B Clemson Cir T CITY OF EAGAN WATER SERVICE PERMIT 3830 Pilot Knob Road P.O. Box 21199 PERMIT NO.: — Eagan, MN 55121 DATE: Zoning: _ No. of Units: — Owner: — izon Address: Site Addess: ?tSOn Cr Plumber: Meter No.: — ._ Connection Charge: Size: Account Deposit: Reader No.: Permit Fee: I agree to comply with the City of Eagan Surcharge: Ordinances. Misc. Charges: Total: / By Date Paid: Date of Insp.: ''t�.rrr Insp.: CITY OF EAGAN SEWER SERVICE PERMIT 3830 Pilot Knob Road P.O. Box -21199 PERMIT NO. Eagan, MN 55121 DATE: Zoning: No. of Units: Owner: Address: Site Address: Plumber: I agree to comply with the City of Eagan Connection Charge: Ordinances. Account Deposit: Permit Fee: Surcharge: B y Misc. Charges: _ Date of Insp.: Total: Insp.: Date Paid: Use BLUE or BLACK Ink u I- (r~nF~ For Office Use- - ~ r ttxr I f ILA C1 ~`i r^ n n~'".- f Permit City of Ea I Permit Fee: J 1 / U 3830 Pilot Knob Road 2 Eagan MN 55122 Date Received: 'I> I Phone: (651) 675-5675 I 1 Fax: (651) 675-5694 1 Staff: I I I 2013 RESIDENTIAL BUILDING PERMIT APPLICATION LOK 'f 3N-6? [Y3/7 H3 173 LA_[CfA5&4 r ` Unit Date: Site Address: t Name:-, 1`*►t c CS I Y`O ~~~r (1,64 Phone: A ! 5~? 2S9- Residentl Q Owner Address / City / Zip: t Applicant is: Owner Contractor i Description of work: 5 I Type ofWork Construction Cost;_ V, ew, TL8 kcs~acint t, s Company: Contact: : ti Contractor Address: N City 1Q- 75 State Zip: Phone . 6?--7q7 : j~GS¢ _Ll -LeaaCertl Ic"f' ate - r If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) !O 1 Itf ~ / ~ 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 inforination. Portions of- the 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+ 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.oooherstateonecall.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 within 180 days of permit issuance, x ~.k ~-.\p 5 x Applicant's Printed Name Applicant's Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA167439 Date Issued:03/15/2021 Permit Category:ePermit Site Address: 4317 Clemson Cir B Lot:6 Block: 2 Addition: The Trails Of Thomas Lake PID:10-75865-02-060 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace & Air Conditioner Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507) 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 - Jacob Weisenburger 4317 Clemson Cir Unit B Eagan MN 55122 Genz Ryan Plumbing & Heating 2200 West Highway 13 Burnsville MN 55337 (952) 767-1000 Applicant/Permitee: Signature Issued By: Signature