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1221 Timbershore Lane Jul 28 2014 09:47AM HP FaxGates G.C. 7634987710 page 8 I � Use BLUE or BLACK Ink �-----------------� � For OffiCe Use � ' j Permitil: �� J� 1� � Clt of Ea�an ; Pe�;�Fee: ����� � 3830 Pilot ob Road j ' I Eagan MN 122 � Dale Received: � � Phone:(651 675-5675 I , I Fax:(651}6 b-6694 I S1aff: I I I , 014 RESIDENTIAL BUILDING PERMIT APPLICATION � J7 i l (;J !7� j`i !-f :� � � 'r� �f�l/T � /L- '�'/�� Dabe: ::.J � Site Address: � �-�� �� � � ,� �.: � ; ��,� •n�s. ° �'=� Unit�: �._._,......_... , __— ->-.-iK.�- cv .'�cov ...._...,.,._ r;.� ._w..,_„_._.._ <_..�,,._..,,.�.... ��,,f_ , .._.. Name: ' � �' �., `"� ,�� Phone� ���' �� ` �-:- � ResidenU Oyyng� Address I City/Zip: S=° Q��✓�' �,..__�,. Applicant is:.,..�,..__,_.Owner _�L�...Contractor .,..,................,...,..._..._.,,_ --_-,....,_. � Type of WOfk Description ot work: ";��' d`�1 /�.'✓�� Construetion Cost: �0, ��• o%� Multi-Family Building: (Yes �� I No� — �,..,�,�.�. ,._...�._...__ _.._...,....,...._......_ _._.__ - --......_........_�._�.__........_..�.. .._. ' � /' /'� L Company: �''�c.S ::�GKG�� '�-�-?�-:�a+!' Contact: �i'�t�:�- � � , � . Contracto� Address: =>S� /'r/.;:c=<.�h i1'� city: ;��`'O�T' � .--, / � state: /�'/'�' zip: S✓�;''r,'' Phone: ✓;�L,'�";...'�fS Email: •�`'"'` `�-'`���°s:��/�x.11�� ,w•�: � _� , i-I 4 ��: - License#: �%= ' �° :.3 Lead Certificate#; � '�'�,� � �%�^--: If the projec!is exe pi from lead certification, please explain why: (see Page 3 for additional irrformation) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING lo the last 12 month ,has the City of Eagan issued a permlt for a similar plan based on a master plan9 _Yes _No It yes,date and address of master plan: Licensed Plumber: Phone: Mechanical Contra or: Phone: Sewer�Water Con actor. Phone: ..,.,,_...._...__ �_...............__ _�....,.,...........�._ ....�.a..,..........._..___ . NOTE:Plans an supporting documents that you submit are considered to be public Information. Portions of the informatior� ay be class�ed as non-public if you provide spec�c ieasons fhat would peim�t the City b _ _..._..__4M conclude that the�are trade secrets. _�_,_�,_�_..___, CALL BEFORE YQ DIG. Call Gophar StatA One Call at(651)451-0002 for proteclion against underground utility damape. Ca�48 hours before you+ntend lo dig receive locates of underground uliliGes. www.000herstateonecall.or4 1 hereby acknowledge th t this infortnation is cort�lete and accurate;that the work will be in conformance with the ordinances end codes of the City of Eagan; that I understan lhis is not a pertnit, Dut only an application for a permil, and worlc is nof to start without a permii; thal the work will be in accorAance wilh Ihe ap ved plan i�the case ot wortc which requires a review and approval of plans. Exterior k authoriz by a building pe H issued in accordance with the Minnes e w Code must be complet within 180 d pe It Issuan . X � x Appll anCa Printed me ApplicanYs natura Page 1 of 3 Use BLUE or BLACK Ink r-----------------� I For Office Use � . � � � /�2 e� i , � ���- :� ��- � � ��� �� �� �� � . ��� .� ��f� i�.�.� �� Permit#: � � £ 1 ' � � � Permit Fee: ��' � � ssso P;iot K�ob Roaa � ��.� OCT 2 3 201� � � � ' , �, � Eagan MN 55122 , � � Date Received: ��'a�' � � Phone: (651)675-5675 '-'�` � � �..:�:_ d.�___._�___�.� � I Staff: Fax: (651)675-5694 �________________i 20�4 RESIDENtIAL PLUMBING PERnniT APPUCaTioN Date: �� r" � �" Site Address: �r-��\ � (,���"�b l�'� Tenant: .� � Suite#: � . ��.�� � �?� Phone�� �1 �� �� �-�j 1� � � �#':�#�l7�1C��1'` Name:�,1�°��� l.l , � � � � , . � F . 1 � v .� � , , Address/City/Zip� , . ��, � . � � ' � . � � � � Name: � � Lic�nse#: � �� � � � � � �, ' i�, f, � �Q�t'1�`8� � ' Address: 1�L��J � � City: i iCC I.,t��� � � � _ � � � ` 4 State:���Zip: ��-� �l�(�` Phone: l �_� ��t�� ��� � � � �' _ . �, � Contact: Email: � � �� � �m New �1 Replacement _Repair _Rebuild _Modify Space Work in R.O.W. � ' � �r����r�� — — � '� � � • Description of work: ��� � RESIDENTIAL � � � � � � Water Heater � �awm trrrgation(�Rf�Z I_PV8) � �Water Softener � � ���_���� ; � _ � � Septic System � Add Plumbing Fixtures�Main/ Lower Level) � � _New Water Turnaround � � � ' Abandonment � ����.,�.�< . — � RESIDENTIAL FEES: � �� � � $60.00 Water Heater, Water Softener, or Water Heater and Softener(includes�5.0o State surcharge) � � $60.00 Lawn Irrigation(includes$5.00 minimum State Surcharge) ` � $60.00 Add Plumbing Fixtures, Septic Svstem Abandonment,Water Turnaround*(includes$5.00 State Surcharge) � � *Water Tumaround(add$200.00 if a 5/8"meter is required) �, � $115.00 Seqtic Svstem New{$10.00 per as built)(includes County fee and$5.00 State Surcharge) � TOTA�FEES$ 7� � � �,,.� � � CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours 6etore you intend to dig to receive locates of underground utilities. www.aopherstateonecall.orq 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 accordar�e with the approved plan in the case of work which requires a review and approval of plans. X � �._� �,�Rl.�', � X �1��-j-�� Applicant's Printed Name Appli nYs Signature ���C������� : '� ': ��r��d By; . ��� �eq����i���t��M .� �..�.,:l�n�r��c�� : #���h�"� ���'�� ,�,,.��'�� : �rn�� . �e�er�t�l�e���� F 1�1���� : > �a�t����t �t� , . :. .-»..:,..-..,.-� . , .-.�..,,�_. . , PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA169133 Date Issued:05/17/2021 Permit Category:ePermit Site Address: 1221 Timbershore Lane Lot:4 Block: 08 Addition: Timbershore 4th PID:10-76503-08-040 Use: Description: Sub Type:Residential Work Type:Replace Description:Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507) 210-0754. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State 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 - Leona L Autor 1221 Timbershore Ln Eagan MN 55123 Apollo Heating & Air 6510 Hwy 36 Blvd N Oakdale MN 55128 (651) 770-0603 Applicant/Permitee: Signature Issued By: Signature