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1995 Glen Echo Bay
l lik) lJ g/~F / lq \1 ~ ~ r I ~~V o Ea a ; Permit I R I cD J I Permit Fee: I 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: ; Phone: (651) 675-5675 I I Fax: (651) 675-5694 i Staff: 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: ~j dV- h Site Address: i 4 c7 ' /q c y e Tenant: Suite RESIDENT / OWNER Name: Phone: Address / City / Zip: Applicant is: Owner Contractor TYPE OF WORK Description of work: T)L' ~©f 12 Construction! Cost: Multi-Family Building: (Yes° / No CONTRACTOR Name: e) )c C6-9 License Address: 2 f ~l -5'6GH71; 2-lel " 5e-., le 2Y,-) City: _&40e"go, State: //-1// Z/ip: Phone: ~P12- c"/,~ 12,0 Contact Person: /7/ lyf •sC~e_ CO PLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 Minnesota Rules 7672 Energy Code Residential Ventilation Category 1 Worksheet New Energy Code Worksheet Category Submitted Submitted submission type) Energy Envelope Calculations Submitted 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 the are trade. secrets. 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 ^ccordance with the approved plan in the case of work which requires a review and approval of plans. App it cant's Printed Name Applicant's Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA126016 Date Issued:08/12/2014 Permit Category:ePermit Site Address: 1995 Glen Echo Bay Lot:022 Block: 02 Addition: Cliff Lake Townhomes PID:10-17790-02-022 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. Lisa Skogen 5660 Memorial Avenue North 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 - Jason R Stafne 1995 Glen Echo Bay Eagan MN 55122 (651) 905-1862 Hoffman Refrigeration & Heating 5660 Memorial Ave. N Stillwater MN 55082 (651) 439-5770 Applicant/Permitee: Signature Issued By: Signature