1869 Casey Tr
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For Office. Use I
t I ^oC,~ I
; Permit
City of a
I
I Permit Fee: I
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 ; Staff: I
Fax: (651) 675-5694 I 1
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Late: 5ite Address: - Ci ZcG'''
Tenant: Suite
RESIDENT / OWNER Name: Phone:
Address / City / Zip:
Applicant is: Owner Contractor
TYPE OF WORK Description of work: / 1~- 7a
Construction Cost: Multi-Family Building: (Yes No
J ~
CONTRACTOR Name: e) T/ Z°-~~ Xy,1,k-7 ~C License G= 2 ~ ~
Address:q 21z9a -:Y/ /GG1't7f ~ 7u le
City: - d/.I f?l?/~. a State: Zip: J:~'1'
Phone: 912- t 38"/~
/ `~LuG~,G;-~ Contact Person: /
COMPLETE 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
(4 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:
MOTE Plans and supporting documents that you tibmit are considered to he'public information Portions of
the information may be classified as non-public ii you provide specific reasons that would permit the City to
conclude_that the are trade secrete,
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 i
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 approv
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Appl cant's Printed Name Applicants Signature
Pag 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA129181
Date Issued:01/16/2015
Permit Category:ePermit
Site Address: 1869 Casey Tr
Lot:131 Block: 02 Addition: Cliff Lake Townhomes 2nd
PID:10-17791-02-131
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.
Applicant: Beth Janohosky
207 150th Street W.
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 -
Michele L Jensen
1869 Casey Tr
Eagan MN 55122
(651) 405-8113
Apple Lake Heating & Air Conditioning
207 150th Street West
Apple Valley MN 55124
(952) 431-4328
Applicant/Permitee: Signature Issued By: Signature