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4439 Lakeshore TerPERMIT City of Eagan Permit Type:Mechanical Permit Number:EA123516 Date Issued:06/10/2014 Permit Category:ePermit Site Address: 4439 Lakeshore Ter Lot:1 Block: 02 Addition: Cliff Lake Shores 2nd PID:10-17786-02-010 Use: Description: Sub Type:Residential Work Type:Replace Description:Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Janel Behrends 122 West 3rd S 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 - Norma C Noonan 4439 Lakeshore Ter Eagan MN 55122 Haley Comfort Systems 122 West 3rd St Hastings MN 55033 (651) 437-0338 Applicant/Permitee: Signature Issued By: Signature Use BLUE or BLACK Ink r-----------------, 1 For Office Use � ��' � Permit#: 1 � j Y � � � � �� � � � �� I Permit Fee: � 3830 Pilot Knob Road � � Eagan MN 55122 � Date Received: � Phone: (651)675-5675 I i Fax: (651)675-5694 i Staff: i 2015 RESIDENTIAL BUILDING PERMIT APPLICATION �Z ��'��s �f'���1 �.�:�,�tsi��.� ��' �' �s���' Date: Site Address: �`�`�Z'� ��°"' �y Unit#: �,� � o ��Name:. •��l��_�4��. .������.,.�_.��.o✓�z..,_�.��,��..� w.�,��,,,�.�.�mPhone:��. � .�,...,.,��.�4� � R�s3�cl�.r��! � l _ � � Q���r � Address/City/Zip: 7�� �' , � � �� � ri���� Applicant is: Owner Contractor �,����"""`"",�..�,a.a�.�..�.�,�.�,w.�..�..�.._.�,.u_.� ��.�m..��..��.�..�..��x_n_,.�.�.Ww.�..�.�.�.�.�..�...��,�.�..�..�.�.�,,..� � Description of work: Wi✓�� �� -ry�� Q�l�rtlr{C � � � � > Construction Cost: Multi-Family Building; {Yes /No_, �� � k� �� Company:��t:t/�t� �hf.�� (��G�1 �hc. Contact: ��-f �'y� r�� �� �� �� I � � � Address �S�b ��G�J�w�� li/J � Su1f� ��% City: +' / � � � G ontra.ctor � State:�Zip: �Sy�� Phone: '7�3-S.S� �bn'�� Email: ��� � �avr�J�ir�iruYwl �1"��y1. � License#: �G ��� ��.3 Lead Certificate#: �,�,.�.,�,.�,�u ���.,�....�.�..�.���,��..�,..A.�.. .m�.W�,�.� ��.���.�..,,��.�.,.,.,�,. �.�.,���.,..��� �..�,-R�„�A �...�.»�.�.�..��.�..���..�a��,�.�,..,�..,..�..,,�.. � If the project is exempt from lead ce�tification, please explain why: ..� _�.,�.�.�..�...��w,��,v��.P ._nv..��m�.��.�.�_..µ,...�,�,�..�...�,,�,..,�.m ....� ._,,.�.�. ..�...,�..>..�. `°"��.`� COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING � � in the last 12 months, has the City of Eagan issued a permit for a simi�ar 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: Fire Suppression Contractor: Phone: N�C3TE':����i5��,s^il�f7d1'�`�1��QkDC1Jt7�Et��`3 th.3�,}�Od15U���f@ C0�13��E�►'@��'O�w�?���li��'�'�I1�11. P�o�tiora�o�' ' t�re i��'or��tion r�ay,be classi�ed as non pub��if y��pro�tate spec��i�rsa��n�t�a#��d�src�i#t�e'Ci�#� � co�d�de tiaat tl�e are t�ade sec�et�, � ��, CALL BEFORE YOU DIG. Call Gopher State One Cali 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.qopherstateonecall.ora 1 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. Exterior work authorized by a building permit issued in accordance with the Minnesota S t Building Code must be completed within 180 days of permit issuance. X �u�S l�rf���,�,��--- X �. ApplicanYs Printed Name Appli s Sign ture Page 1 of 3