1525B Clemson Dr CITY OF EAG4N WATER SERVICE PERMIT
3795 Pilot Knob Road PERMIT NO.:
Eagan, MN 55122 DATE:
Zoning: No. of Units:
Owner:
Address:
Site Address:
Plumber:
Meter No.: _ Connection Charge:
Size: Account Deposit:
Reader No.• Permit Fee:
agree to comply with the City of Eagan Surcharge:
Ordinances. Misc. Charges:
Total:
By Date Paid:
Date of Insp.: Insp.:
SEWER SERVICE PERMIT
3795 Pilot Knob Road PERMIT NO.:
Eagan, MN 55122 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:
Surcharge:
By Misc. Charges:
Date of Insp.: Total:
Insp.: Dote Paid:
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Use BLUE or BLACK Ink
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For Office Use I
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City of tap Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 1 Staff: I
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2013 RESIDENTIAL BUILDING
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Date: Site M~ IT A~P` lPL~ jIC V t ATION
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"je Y I o Address:
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Name: 1
Resident! - ~ - ` , '
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Owner Address / City / Zip:
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Applicant is: Owner Contractor
Type of Work Description of work: ~ 11 W4 CAffAA Limului CAI - 91& m Nf
Construction Cost: V Multi-Family Building: (Yes X / No )
Company: LL f1occ IY)0) a-A't Q2"_d(d rnJ `Eontact: ~&Uwt yr `V 1
Address: CI )()G f ,~C11~SIC~v- 6%Jd City: _S4 LC3u-
Contractor
State: MV Zip: S~y Phone:
License 0-1Q_0D LU 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. 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.
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.cioi)herstateonecall.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.
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Applicant's Printed Name App ' 1Vs ig ature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA175458
Date Issued:04/05/2022
Permit Category:ePermit
Site Address: 1525 Clemson Dr B
Lot:13 Block: 03 Addition: Thomas Lake Heights
PID:10-75950-03-130
Use:
Description:
Sub Type:Furnace & Air Conditioner
Work Type:Replace
Description:
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 -
Mesfin Senbeta
1525 Clemson Dr Unit B
Eagan MN 55122
Centraire Heating & Air Conditioning Inc
6811 Washington Ave S
Minneapolis MN 55439
(952) 941-1044
Applicant/Permitee: Signature Issued By: Signature