1245 Timbershore Lane Jul 28 2014 09:49AM HP FaxGates G.C. 7634987710 page 14
Use BLUE or BLACK Ink
� ForOHieeUse---------�
�it of Eao� ; Pertnitit ! ��� / I
b � Pertnil Fae: � (_� �
3630 Pilot ob Road �-7
Eaga�MN 122 � Date Received: l * �
Phone:(65 �675�5675 I I
Fax:(B51) 55694 � Staff: I
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; o�a RESiDENTIAL BUiLDING PERnnir aP��icarioN
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Oate: • � SiteAddress: -' � ' � ` � •� � Unit#:
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� Name: �'I'LlSfi�'..�izC��� r';�ll�, Phone: ��;�,�,;✓� �J!?:',
� Resident/
Owner Address I City/Zip: ;�Ct� �b�! '
Applicant is: Owner '� Contractor
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Type of Work �scription ofwork: ' `-�'" �,� ��"l�"� �
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Construction Cost: � �� � Mulli-Family Building:(Yes '� /No�
Company: 7�G°" � ,,�iu� �� �,r<!%1%Y Contact: /%/�.� •'-z-� �
COf1t�21Ct0� Address: 3, 7'_' :/:,i�j�"'u'N �:/�'f 1`'"� Cily: �i%lilsn:,vi__
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� state� I�f 1 zip: SS';:�:! Phone: {�=- �s-'� ..; Ema iL• ��s�:�2.;• � ���:iP,•�+�'•a!=�''� _'.:;e-..�.
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� Licenae#: Lead CertificaLe#: /
If�the project is ex pt frorn lead certification, please explain why: (see Page 3 for additional information) '
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� COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING ~ Y
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� In the last 12 mont ,has the City of Eagan Issued a permit for a similar plan based on a mastor plan7
�� _Yes _No I yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contra or: Phone:
Sewer&Water Con actor: Phone:
NOTE:Plans an supportlnq documents that you submit are considered to be public infarmafion. Portions of
the informatior� ay 6e c/assified as non public if you provide speclifc reasons thaf would permif the City te
°` _.,,_,,,,,__,__, � � ��conclude that fhey are trade secreis. �_�..�,.V
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CALL BEFORE Y DIG. Can Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours
Detore you intend to dig receive locates of underground utilities. www.000herstateonecall.ora
I hereby adcnowledge t this information is oomplete and accurate;thal the work will be in confortnance with the ordinances and cades of the Cily of
Eagan;that I undersla this is not a permil, but only an application for a pertnit, and woric is nol to slart wilhout a permit Ihat the wartc will be in
accordance wilh the app ved plan in the case of work which requires a review and approval of plans.
Exteriorwork a by a building permlt Issued in accordance wilh fhe Minne Sta Building Code must complotad wlthln�80
days of i nc .
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Appllcant's mte�i ame Ap i s Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA137248
Date Issued:06/24/2016
Permit Category:ePermit
Site Address: 1245 Timbershore Lane
Lot:4 Block: 06 Addition: Timbershore 3rd
PID:10-76502-06-040
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.
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 -
Mary L Peterson
1245 Timbershore Lane
Eagan MN 55123
(612) 718-8932
Air Rite Heating & Ac Inc
6935 146th Street West, #3
Apple Valley MN 55124
(952) 683-1900
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA145493
Date Issued:09/12/2017
Permit Category:ePermit
Site Address: 1245 Timbershore Lane
Lot:4 Block: 06 Addition: Timbershore 3rd
PID:10-76502-06-040
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
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 -
Mary L Peterson
1245 Timbershore Lane
Eagan MN 55123
(612) 718-8932
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature