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
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' i Name: ~ O) O TI ~ a 1`11 AS L IL - Phone: ZoQj 2~/7 ZQZ
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Owner. Address / City / Zip: 0 ~ Q 0 C
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- 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
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State: V V\
Zip:- Phone" 7 (4 7-
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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
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