4146 Beaver Dam Rd
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I For Office Use
Permit GQ
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Qll Il I S
I Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 I I
I Date Received: I
Phone: (651) 675-5675 I
Fax: (651) 675-5694 I Staff: I
L-----------------
2013 COMMERCIAL BUILDING PERMIT APPLICATION - 12 UY1 t tS
Date: '1 d17 Site Address: yv
gvCr are.
Tenant Name: Coe ftj 0,1 (;,.,1 ko+nt$(Tenant is: New / i`-, Existing) Suite
Former Tenant:
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Name: D;MtN C.or%ho.,s ;L \j%kk&s ot^j !~gCL,& "S Phone: AS*A- 4 3 a- 817 9
Property Owner Address/ City /Zip: ?b D42X N>3 et ho\)V% (of?
Applicant is: Owner Contractor
Description ofwork~eac- Oicr Qnc- (,oo~ a!, C1~rar 5 .vh Ct ^'C`
Type of Work
Construction Cost: b~~q
Name: O T License \J .C~ 1 t et
a a Address: ~Aojv lee, o•vL City: q 10!5C_ 0jV%A-
Contractor
State: M ~J Zip: ';J5'0(~sn Phone: !Tcs-l - 21 ;L` ~ 9 (as
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? Contact: LG-► Email: ~f j kd V ek( e, 6
Name: Registration
Architect/Engineer Address: City:
State: Zip: Phone:
a 2
Contact Person: Email:
Licensed plumber installing new sewer/water service: _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 y
conclude that they 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.got)herstateonecall.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.
x Lc~j_ I o V x - r}nu. -
Applicant's Printed N e Applicant's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA153138
Date Issued:11/26/2018
Permit Category:ePermit
Site Address: 4146 Beaver Dam Rd
Lot:009 Block: 04 Addition: Diffley Commons 2nd
PID:10-20451-04-009
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.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
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 -
Matthew R Fitzke
4146 Beaver Dam Rd
Eagan MN 55122
Genz Ryan Plumbing & Heating
2200 West Highway 13
Burnsville MN 55337
(952) 767-1000
Applicant/Permitee: Signature Issued By: Signature