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3781 Robin LanePERMIT City of Eagan Permit Type:Mechanical Permit Number:EA128290 Date Issued:11/03/2014 Permit Category:ePermit Site Address: 3781 Robin Lane Lot:10 Block: 01 Addition: Blackhawk Acres 3rd PID:10-14302-01-100 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace & Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Heather Winn 21210 Eaton Avenue 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 - Carole J Klecker 3781 Robin Lane Eagan MN 55122 (651) 452-0085 Controlled Air 21210 Eaton Ave Farmington MN 55024 (651) 460-6022 X253 Applicant/Permitee: Signature Issued By: Signature 09/30/2013 09:55 6513447137 AMANDA HANSON PAGE 02 Use BLUE or BLACK Ink - ^ For Office Use j Permit 0: ' 15 S;J 1 I City of Ealan I 51 .s© Permit Fee: 1 3830 Pilot Knob Road I I Eagan MN 66122 Date Received: j Phone: (661) 6784876 Fax: (851) 675-6894 1 Staff; 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: site ddresss 3"1 ' 77 3 7 Name: Phone(iiil Address I City /Zip: Ltj ~}a " Applicant is: _ Owner Contractor Description of work: I~,C~.d1V Y -T~ -63 Construction Cost: ~ CCO, 00 Multi-Family Building: (Yes -YI/ No Company:SMW)~ UL-T) Contact: LSI Address: t2,zbO 6c)L,0-T AIQ S City; Rum 11 /AYI-ra~KI State: Jat4 Zip: 55431 Phone: lQ ( ~l~ L ~Izl License ~C-b 3 j Lead Certificate 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 6 Water Contractor: Phone: ~ - t • 'r• ° iii IN s.: 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. mM.9Qoherstaleonenall.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 review and approval of plans. Exterior work authorized by a building permit issued In accordance with the Minnesota State Building Code must be completed within 180 days of pemMt Issuance- x x Ap Ilcant's Printed Name ' 1 L~~ pl nt's Sgnature 6 Page 1 of 3 05/02/2014 14:30 (FAX) P.001/003 Use BLUE or BLACK Ink I - For Office use I Permit 0: 12 y3 City of Pap -7 3, 3 r 1 I Pannlt Fee: 3630 Pilot Knob Road Eagan MN 55122 Date Received: Phone:(651)675.5675 I I (Stall; I Fax: (651) 675.5694 .31 -3 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 'S-2-t Site Address: a?7 3 'S-?V-7 TZdb ,Lam, Unll X: Name' Phone: Resldent7, Address ! City I Zip: I; 'w Applicant Is: Owner Contractor C. i; Description of work: _ t_w ^ t'8^ ~t S ~c Type of Work . ;i ;A I ;,1.;, i Construction Cost: "3 f't ~UU. c, Multi-Family Building: (Yes / No I' Company: u1a A ce) 6 S4/u L. ~t U,-, Contact: `Je. va C C 1' Address' CXOV tv. OltrAdtor b o l~- &k::r S City: 7~%1 vin ow., uA ~o State: jMZlp: :i2a{ L Phone: ee t. a.- '3 33 EM811: c D Y-A Q r, IN <<nri..JUi C. ?(o ' License Gr uen (a ( Lead Certificate k) A T' (1 CJY If ^ If the project Is exempt from lead eartiflcatlon, please explain why: (see Page 3 for additional Informatlon) 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: O.TE:!P,.lana andsupporting,documan'94tt at~yoi~4 if 11brn 'are 'conslderedl't ` "udllc;'lnforriiat/onPoitiers"of'!!! r.:!lofo'rr itlon;ma less.I:,.l.f/od.un,'a8; d :n,i: roola . i : : n.,, ai,.. L . ~r r,:. u•Gr .I,.. d,~elp,..n.,, ..,I I, L the.: ,nvn;puliNclliyou, piT~ v/de:;apeclilc reaso sit/iat;would:per 1t;~C/ty'rollil'I yc . ;uy~.d,l ,•..~h";I~.p~ rLr .a,: diz ,L:... i' n. cn,i.n.vrc i,.,,•~ ,I~IrPhi p,;'fi rir•. ~ ,P.i I'itr~Il P ! I.• II ~ G.i i ' I iconc/ual 00 th`e LLIIjji!Iji CALL BEFORE YOU DIG. Call Gopher State One Call at (831) 454-0002 for protection against underground utility damage, Cell 48 hours before you Intend to dig to receive locales of underground utilities. www,pooherstateonecall.om 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 review and approval of plane. Exterior work authorized by a building permit Issuad In accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. X ~ar ~-cnVW x Applicant's Printed Name Applicant's Signature Page 1 of 3