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2212 Water Lilly Lane Use BLUE or BLACK Ink r For Office Use Permit 113 to9LA Y Cat of EaRan Cp50 . Sa I Permit Fee: 3830 Pilot Knob Road I ~ Eagan MN 55122 I Date Received: -IJ 3 I Phone: (651) 675-5675 I I ~9. Fax: (651) 675-5694 j Staff: l5_ C> I L-----------------I 2013 131"ILDING PERMIT APPLICATION Date." Site Address: Tenant Name: T errant is: New / Existing) Suite Former Tenant: Name: Phone: Property Owner Address / City / Zip: Applicant is: Owner Contractor Type Work Description of work. - - r Construction Cost v Name: License Address: City: State: Zip: Phone: Contact: Email: Name: Registration Ar hitect6E gi eer Address: City: State: Zip: Phone: Contact Person: Email Licensed plumber installing new sewer/water service: Phone NOTE: Plans and supporting documents that you submit are considered to he public information. Portions o® the information may be classified as non-public if you provide specific reasons that would permit the City to conclude Jiat then 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.gopherstateonecall.orq 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 wok which requires aveview and approval of plans. U x,t x~~ m Applicant's Printed Name Afsp,rant's Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA116856 Date Issued:10/11/2013 Permit Category:ePermit Site Address: 2212 Water Lilly Lane Lot:701 Block: 02 Addition: Eagan Heights Townhomes 1st PID:10-22425-02-701 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Lisa Skogen 5660 Memorial Avenue North 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 - Charles H Skelton 2212 Water Lilly Lane Eagan MN 55122--193 (612) 839-5665 Hoffman Refrigeration & Heating 5660 Memorial Ave. N Stillwater MN 55082 (651) 439-5770 Applicant/Permitee: Signature Issued By: Signature 07/07/2014 11: 47 7635193932 PAGE 01/02 Q4,�19120Sq 12:3� y��5�9�g,2 PAQE 01/51 U�o�I,�I�+Dr BLA�IC Ink �,�.__.�.,, � '~FOt CMlan U��0 ���� I I ��Y 0���� � �lOt L q 1(lf � �:m,���; � � J � i Pertnrt Eens � � 3@aA�ilc��nob Raad Q������� � --���-�►-�---, i E;�g�MN�' '1�^'iG � t�stu l�a�iuetr �hone:(651)b7s�679 � staff: M� _r_.,..^�� Fax:(6�h)�6-55� ..^ _ I w��'!4���6��ID�i����. 6��.��'�19E3lNC F'�RlIAIT APP�,I�.I�TION ' c�,�� `�'-�" � `� s�,����:,,.s�Z.�- � a- ��=`�.er C..� � �� L��� - ._---�— 'Y�n�a�n� Suibe�: •___._—�-- �� ��'2��E��hkIaY�1ET' Narrl�:�, �Yr! � S�C.�'�C.y►1 _ Phbf1�,�„(�,�,��J�_-y—I"�`5� � �.� Addrnss r Cf I Z� : G1 e � �-cc..�1. ; � �. � ' ', Npxrre• �A�CU" ��-6 p'1'�t� _,,,,.l.icen�u��, /►'1 L��S� 7 ro _ � �, �� �� �. . .� �,d��,: I�s,,��- '��#�h_�4,�.N �r� �. � �►'n�--`� �` �---N �,,,,�corr�i��or� . . ,� . �. �cs�ro: V�.Lt-� zra S S � r�►o�,: �l., � �/`�.���-- . , 1 : ' CoNaa: � Bmr.,14„�S�C�. ► 't ��) ���,.CO _ �-� ..'ti"j;1�1�I�'�llll�l'�• ^--N�w ,�,Replacemerit �R�p�ir ,,,,,_„Rebuilct ,,,_,Modify Space _,,,1�lark in R.C1.W. , •'�� • �P+�iL'�'�I��OMA�3FMiDf�C: I , , R�stlo�rna� ', � . � � � ,,,�,Wot�r Me�tesr �',, ,. • "� � _l�wn 1�Isflwti(,,,,�RPZ/_,PVS) ---^�Wa'ter 8aflaner ' ,1�i�1'�11YiC Ty�i��' _..Add Plumbinq Phd►►r�a(_„Maln�,_.,.,,�,ower I.svml) ' , ,.,^.._.Septie sys�im . 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