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4303 Clemson Cir BPERMIT City of Eagan Permit Type:Building Permit Number:EA107385 Date Issued:10/09/2012 Permit Category:ePermit Site Address: 4303 Clemson Cir B Lot:19 Block: 02 Addition: The Trails Of Thomas Lake PID:10-75865-02-190 Use: Description: Sub Type:e-Fireplace Work Type:Gas Insert Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to concealing. Carbon monoxide detectors are required by law in ALL single family homes . Valuation: 3,000.00 Fee Summary:BL - Base Fee $3K $88.50 0801.4085 Surcharge - Based on Valuation $3K $1.50 9001.2195 $90.00 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 - Shannon M Haugh 4303 Clemson Cir Unit B Eagan MN 55122--188 Hearth and Home Technologies 2700 N. Fairview Ave Roseville MN 55113 (651) 638-3309 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA111635 Date Issued:07/05/2013 Permit Category:ePermit Site Address: 4303 Clemson Cir B Lot:19 Block: 02 Addition: The Trails Of Thomas Lake PID:10-75865-02-190 Use: Description: Sub Type:Residential Work Type:Replace Description:Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Phil Holmin 900 Park Knoll Drive 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 - Shannon M Haugh 4303 Clemson Cir Unit B Eagan MN 55122--188 Applicant/Permitee: Signature Issued By: Signature CITY OF EAGAN Permit No: Date: 3830 Pilot Knob Road Meter No: Size: P.O. Box 21 T99 Reader No: Date: Eagan, MN 55121 Owner: Site Address: Plumber: Conn. Chg: Zoning: Acct. Dep No. of Units: Permit Fee: Surcharge: I agree to co ply with the City of Eagan Tr. Plant Ordinance . Meter: ,zc 5 7r7 Misc.: By WATER SERVICE PER CITY OF EAGAN SEWER SERVICE PERMIT 3830 Pilot Knot) 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: By Misc. Charges: Date of Insp.: Total: Insp.: Date Paid: i Use BLUE or BLACK Ink r----------------- t~ I For Office Use ~.t,✓ j Permit ( t I City of Eano n I Permit Fee: $C d 0 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651)675-5675 I 1 Fax" (651) 675-5694 1 Staff: I I , - - - - - - - - - - 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date (10 L( > Site Address: ~tV 3 ' ?0313 'f ~O S ~f3C'Sf3 Ck gL"" f Unit ~ ' i Name: ~ O) O TI ~ a 1`11 AS L IL - Phone: ZoQj 2~/7 ZQZ f Resident/ -T Owner. Address / City / Zip: 0 ~ Q 0 C i - t Applicant is: Owner X Contractor i Description of work: ASIPh# It trD b' P~P J~ICC'~S I Type of Work -T h Construction Cost:... Company: TL8 Contact: i Address: City: Contractor V\ 76. State: V V\ Zip:- Phone" 7 (4 7- I t _ -L-i~„32-#_• ea e I Ica e 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 andsupporfing documents that yousubmit are considered to be public information. Portions of i 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,gooherstateonecall.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 Eagaih; 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 tale Buil ing Code must be completed within 180 days!o,f permit issuance x l~ YS x Applicant's Printed Name A s Signature Page 1 of 3