1063 Duckwood Dr - Unit 201
Use BLUE or BLACK Ink
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For Office Use Cit an ; Permit [ -3 ~
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3830 Pilot Knob Road I Permit Fee:
Eagan MN 55122 I I
Phone: (651) 675-5675 Date Received:
Fax: (651) 675-5694
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2012 MECHANICAL PERMIT APPLICATION
❑ Please submit two (2) sets of plans with all commercial applications.
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Date: Site Address:
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Tenant: Suite
Name~ly:~
PPhone:~,
RESIDENT / OWNER
Address / City / Zip:
Name: License
CONTRACTOR Address: City:
State: Zip: Phone:
Contact: Email:
New Replacement Additional Alteration Demolition
TYPE OF WORK Description of work:
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
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$10,010-$11,010 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.-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.
Applicant's Printed Name Applicant's Signatu
FOR OFFICE USE
Required Inspections: Reviewed By: Date:
Underground Rough In Air Test Gas Service Test In-floor Heat Final HVAC Screening
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA145026
Date Issued:08/21/2017
Permit Category:ePermit
Site Address: 1063 Duckwood Dr 201
Lot:138 Block: 04 Addition: Lexington Place 2nd
PID:10-45051-04-138
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 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 -
Katherine Loeffler
1063 Duckwood Dr 201
Eagan MN 55123
Renewal Andersen
1920 County Road C West
Roseville MN 55113
(651) 264-4777
Applicant/Permitee: Signature Issued By: Signature