2222 Water Lilly Lane
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Use BLUE or BLACK Ink
I For Office Use
I 1 I I cely of Eap Permit 1 co l0
I I
I Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 j Date Received: 5
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Phone: (651) 675-5675
Fax: (651) 675-5694 I Staff: I
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2013 COMMERCIAL BUILDING PERMIT APPLICATION
Date: - Site Address:
Tenant is: New / Existin Suite
Tenant Name: (g)
Former Tenant:
Name: Phone:
Property Owner Address /City /Zip:
Applicant is: Owner Contractor
Description of work:
Type of Work
a
Construction Cost: 3Z4 j d,
Name: License
Address: - - City:
,tor
State: Zip: Phone:
Contact: Email:
Name: Registration
ArchitectfEngineer 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 of
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 Gall 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;.,eview and approval of plans.
r
a € x r -
Applicant's Printed .',lame Ap ant's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA156335
Date Issued:06/25/2019
Permit Category:ePermit
Site Address: 2222 Water Lilly Lane
Lot:604 Block: 02 Addition: Eagan Heights Townhomes 1st
PID:10-22425-02-604
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.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 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 -
Kimberly A Elumba
2222 Water Lilly Lane
Eagan MN 55122
Haley Comfort Systems
4320 Hwy 52 N
West Frontage Rd
Rochester MN 55901
(507) 281-0138
Applicant/Permitee: Signature Issued By: Signature