2212 Water Lilly Lane
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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. - -
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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.
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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
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