1867 Ruby Ct N
Sep 30 13 08:53a LS West, Ilc 9522368445 p.3
Use BLUE or BLACK Ink
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l For Office Use 1
MY Pemnit#: of ~ata~
; Permit Fee:
3830 Pilot Knob Road 1 1
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 1 I
Fax: {651) 675-5694 1 Staff: 1
1 I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: , O (3 Site Address: 1W ~~9 7 f ~a 0.l0 Unit
Name: f1 I l' a. ywwi':4 4" ~h i d t -}~dvt Phone:
Resident!
Owner Address / City / Zip:
Applicant is: Owner /t Contractor
Description ofwor>t: I CQi- Ott 't 1 ~6j:'kpb~i~d✓I S~ie-
Type of Work
Construction Cost' 33 .47 Multi-Family Building: (Yes ! No
Company: Z< Contact: Leb llii'rl~,I
Address: 14 b q 2e Z{ CaGI Fes- City: L A le V, eJ
Contractor i }1 J r
State: Zip: t"lf"'1 S 0 Phone: V) ) '114
r1it
License A ~6 Lead Certificate # 1 " "f g r
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 and supporting documents that you submit are considered to be 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 Call at (651) 454-()002 for protection against underground utility damage. Call 48 hours
before you Intend to dig to receive locates of underground utilities. www.gooherslateonecail.org
I hereby adcnowledge 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 orgy an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plait in the caseof work which requires a review and approval of plans.
Extenor work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
x S,cr~ Jesk x
Applicant's Printed Name Applic is Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA166291
Date Issued:12/29/2020
Permit Category:ePermit
Site Address: 1867 Ruby Ct N
Lot:090 Block: 03 Addition: Diffley Commons 2nd
PID:10-20451-03-090
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507)
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 -
Catherine Sexton
1867 Ruby Ct N
Eagan MN 55122
(808) 651-9087
Hero Plumbing Heating & Cooling Inc
10900 Hampshire Ave S
Minneapolis MN 55438
(612) 827-4674
Applicant/Permitee: Signature Issued By: Signature