3273 Dodd Lane VILLAGE OF EAGAN WATER SERVICE PERMIT
3795 Pilot, Knob Rood 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:
I agree to comply with the Village of Eagan Surcharge:
Ordinances. Misc. Charges:
Total:
B y Date Paid:
Date of Insp.: Insp.:
VILLAGE OF EAGAN SEWER SERVICE PERMIT
3795 Pilot Knob Road
Eagan; MN 55122 PERMIT NO.:
Zoning:
DATE:
Owner:
No. of Units:
Address:
Site Address:
Plumber:
I agree to comply with the Village of Eagan Connection Charge:
Ordinances.
Account Deposit:
Permit Fee:
Surcharge:
By:
Misc. Charges:
Date of Insp.:
Total:
Insp.: Date Paid:
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA110657
Date Issued:05/21/2013
Permit Category:ePermit
Site Address: 3273 Dodd Lane
Lot:273 Block: 10 Addition: Selmark
PID:10-67100-10-273
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Ashley Orman
130 Plymouth Ave N
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
Surcharge-Fixed $5.00 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 -
Kevin H Gullickson
3273 Dodd Lane
Eagan MN 55121
(651) 994-1609
Standard Heating & Air Conditioning
130 Plymouth Ave. N
Minneapolis MN 55411
(612) 824-2656
Applicant/Permitee: Signature Issued By: Signature