unit F Oct 2 2014 12. 05PM Crest Exteriors 651-463-8095 P. 5
Use BLUE or BLACK Ink
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� For Office Use
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Clty of Ea�a� , Permil#: I
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� Permll fes: �
3830 Pilot Knob Road j GZ � f j
Eagan MN 66122 � Da1e Recelved: V �
Phone;(661)676•5675 I Staff: �
Fax;(661)676-5694 � �
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2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date:I� Site Address: ' Unit�I:
Name:l� Phon��,�J���7�1� (1\���
ResiilenU P - . � �
��''�' Address/Ci p
Owner h+/zt �
����,;,:_ ;,t•;.::,�,. : Applicant is: Owner Contractor
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��R �a'�''�P`' Descrlption of work: - '
s e'of, o��
�'�.r..�� �l. /�
"�-'' ' Canstruction Cosl:� v`� y Buildin :(Yes�1 No_�
� Multi-Famil g
:- ,. .. • Company:l J► �(�jl x�,( �1)1 J� LLJ� i _ContacL��,,�
,';�� �:: Address:�7 � I 1 � (\����Clty: .
�;f3ontractor
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• State:�Zip� lJ��'�' Phone: � `�mall:��,s1�T�.���r�� �Q,��2�r►�t
License#:���\Y�7-�'�VJ���� Leed Ce�tificate#:
If the project is exempt from lead certfflcatlon, please explain why: (see Page 3 for additional information)
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COMPLETE THIS A A ONLY IF CONSTRUCTING A N�W BUILDING
In the last 12 months,has the Clty of Eagan issued a permlt for a similar plan based on a master ptan9
,�Yes _No If yes,date and address of master plan:
Llcensed Plumber. Phone:
Mechanfcal Contractor: Phone:
Sewer&WaEer Contractor: Phone:
NOTE:Plansandsu;���tl"� 'cu"`'e�� -Y�a�+q!/; ��i `�`r'e'cq P ')'E�'_o�lii.e' ubllcinfo►7ndtion. Port7onsof
tfie informe'`�%n htay�°classif -i�y ��c' �. , ��would permi��Iie�City to
.. _ . . ,- : . `_`Eo � e_ a��t r,a ts . .. � . '
CALL BEFORE YOU DIG. Call Gapher Stete Ona Call al(ebi)464•0002(o�protecllon againsl undefground ulility damage, Call 48 hours
before you i�lend lo dlg to recelve locales of underground uIIllUes. www. o hersl e Il.or
1 hereby acknowledge thal lhis inforrnalion IS complete and accurale:lhal the work wlll be in con(ormance wlth lhe ordinanc�snd codes of lhe City of
�agan;lhal I understand►hls Is not a permil, but only en appllcallon for a permil, end wollc fs not lo sleri wilhout a permll; Ihal lhe work v✓�II be in
accordence wllh the approved plen(n lhe ease of work which requifes e fevlew and approval of plBnS.
Ezterlor work authorizad hy a bullding permit issued In aeeordance wlth the Minne6ota Slale 8ullding Cada must 6a compleEed witnln 180
days of parmll Issuance.
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Applicant's P�Inted Name Applic nt's Slgnature
Page 1 oF 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA174102
Date Issued:12/27/2021
Permit Category:ePermit
Site Address: 3612 St Francis Way F
Lot:009 Block: 05 Addition: St Francis Wood 4th
PID:10-65903-05-009
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507)
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 Susan Tste Sacksteder
8816 Raiders Run Rd
Cincinnati OH 45236
(651) 263-8992
Minneapolis St. Paul Plumbing Heating Air
640 Grand Ave
St. Paul MN 55105
(651) 228-9200
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA175180
Date Issued:03/17/2022
Permit Category:ePermit
Site Address: 3612 St Francis Way F
Lot:009 Block: 05 Addition: St Francis Wood 4th
PID:10-65903-05-009
Use:
Description:
Sub Type:Furnace & Air Conditioner
Work Type:Replace
Description:
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507)
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 Susan Tste Sacksteder
8816 Raiders Run Rd
Cincinnati OH 45236
Minneapolis St. Paul Plumbing Heating Air
640 Grand Ave
St. Paul MN 55105
(651) 228-9200
Applicant/Permitee: Signature Issued By: Signature