1221 Timbershore Lane Jul 28 2014 09:47AM HP FaxGates G.C. 7634987710 page 8
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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
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014 RESIDENTIAL BUILDING PERMIT APPLICATION �
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Dabe: ::.J � Site Address: � �-�� �� � � ,� �.: � ; ��,� •n�s. ° �'=� Unit�:
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Oyyng� Address I City/Zip: S=° Q��✓�'
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Type of WOfk Description ot work: ";��' d`�1 /�.'✓��
Construetion Cost: �0, ��• o%� Multi-Family Building: (Yes �� I No�
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Company: �''�c.S ::�GKG�� '�-�-?�-:�a+!' Contact: �i'�t�:�-
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Contracto� Address: =>S� /'r/.;:c=<.�h i1'� city: ;��`'O�T'
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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:
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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 .
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Appll anCa Printed me ApplicanYs natura
Page 1 of 3
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ssso P;iot K�ob Roaa � ��.� OCT 2 3 201� � � � '
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Eagan MN 55122 , � � Date Received: ��'a�' � �
Phone: (651)675-5675 '-'�` � �
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I Staff:
Fax: (651)675-5694 �________________i
20�4 RESIDENtIAL PLUMBING PERnniT APPUCaTioN
Date: �� r" � �" Site Address: �r-��\ � (,���"�b l�'�
Tenant: .� � Suite#:
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Address/City/Zip� , . ��, �
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� �Q�t'1�`8� � ' Address: 1�L��J � � City: i iCC I.,t��� �
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Contact: Email: �
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� �m New �1 Replacement _Repair _Rebuild _Modify Space Work in R.O.W. � '
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� • Description of work: ���
� RESIDENTIAL �
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� Water Heater �
�awm trrrgation(�Rf�Z I_PV8) � �Water Softener �
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� Septic System � Add Plumbing Fixtures�Main/ Lower Level) �
� _New Water Turnaround �
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� ' Abandonment �
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� 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� �
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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.
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Applicant's Printed Name Appli nYs Signature
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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