3778 Grey Dove Lane
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Use BLUE or BLACK Ink
For office Use
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Permit 16 ,3` (10
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City of Ea
~ Permit Fee: ~ 1 I ac.5 . D ~J i
3830 Pilot Knob Road t t
I Date Received: 12CI I t-,7 I
Eagan MN 55122 I I
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 l Staff t
L---------------- I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION j,
• - - ~ 3790 7r`'? LAILI-
Date iCT-a~'t3 Site Address: 37L4 3~7,a, 377N 3775, 3')80. 3-)Sy, Unit#:
F----- ---..........e_..o.~ Name: Phone:
Resident/
I Owner i Address /City /Zip:
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i
Applicant is: Owner Contractor
Description of work: Q
Type of Work i ^
; Construction Cost: d Ol a0z) Multi-Family Building: {Yes / No
Company: ~~~°ta2~~f1 no>fct~ ar,' Contact: d~
I i Address: City
Contractor i z#
State: tyl A ~ Zip: 10"53 -1 Phone:
( License #`f 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 & Water Contractor: _ Phone:
1 NOTE. Plans and supporting documents that you submit are considered to be public information. Portions of
f the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that rheyare trade secrets
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protectinn aciainst underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. ,
I hereby acknowledge that this information is complete and accurate; that thr, ,r rk 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 pem-tit, stud 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 permit issuance.
Applicant's Printed Name Applicant's Signature
Page 1 of 3
Use BLUE or BLACK Ink
City of Eapft For Office Use
460 a--
Permit#: I .
Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122
Date Received: /6 ''''?v-i7
Phone:(651)675-5675 *
Fax;(651)675-5694 ' '•"/
1 ;4.
Staff:
--"7.
L
2017 MECHANICAL PERMIT APPLICATION
P1 Please submit two(2)sets of plans with all commercial applications.
/-,
Date: /0 - 24.--1 1 Site Address: 377E/ (.../or-e.‘1* i.) I t• 4-11
Tenant: Suite#:
Ilk." • 4.4a it 04 .
Name: '' 5,, mil& Ti..„2, Phone.
esidentiOvvner _
Address/c4/zip: ,.._ _... _ ........_..... _ ,
. 5-'111 ' Illtilli - I Nik di
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i-ka
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Nam-. ilk "" 41iiill lik 4 .. -. License#: Ilk 0./aa. ....
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contractor Address: '-'-lik1119:411"11/4111111 : '''' Citr‘fly: 6:1"\71\r3 -461r9%--
State: r44\s,.. Zip: („ I,...31 CI"
Phone: k---1),$) ri-4 - ,--t,(- (:)
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Contact: , ' c(41., (lick'V-kr) Email: 'ti A fe,,,... 'w A 'a N4...A.
s,..
.. 4, New Replacement Additional Alteration Demolition
,.
Type of Work Description of work: -7 i%I & It sik & A
NOTE', Roof mounted and ground mou'. - . mechanical equipment is required to be screened by City
Code. Please contact the Mechanical Inspector for information on permitted screening methods.
RESIDENTIAL COMMERCIAL
Furnace
I New Construction Interior Improvement
,-' Permit Type _Air Conditioner I Install Piping Processed
Air Exchanger Gas —Exterior HVAC Unit
Heat Pump • Under/Above ground Tank ( Install/ Remove)
--7-
r Other tol'i ta,,,,, etimit il
. ,
RESIDENTIAL FEES
$60.00 Minimum Add or alteration to an existing unit, includes State Surcharge (..ci 4 0
$100.00 Residential New,includes State Surcharge .$ ., TOTAL FEE
COMMERCIAL FEES Contract Value$ x.01
$60.00 Permit Fee Minimum 1 (P ) ' Permit Fee$75.00 Underground tank installation/removal,includes State Surcharge .$
,...
=$ Surcharge
Surcharge=Contract Value x$0.0005
If the project valuation is over$1 million,please call for Surcharge =$ TOTAL FEE
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.
't"gf f
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Applic t's Printed Name Appli ant's S ,i,nai rqL.,,,,e
FOR OFFICE USE
Required Inspections: Reviewed By: Date:
Underground Rough In Air Test Gas Service Test In-floor Heat Final HVAC Screeni
ng
_ _____ ______ _ ____ ____ _____
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA146695
Date Issued:11/07/2017
Permit Category:ePermit
Site Address: 3778 Grey Dove Lane
Lot:4 Block: 20 Addition: Town View 1st
PID:10-77100-20-040
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.
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 -
Everett J Goodridge
3778 Grey Dove Lane
Eagan MN 55122
Applicant/Permitee: Signature Issued By: Signature