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unit G O�t 2 2014 12: 05PM Crest Exteriors 651-463-8095� P, 7 � � Use BLUE oP BLACK Ink � For Offlce Use �~^ � ' � Permit ii: �� I C�ty of Ea�a� � Permil Fee: / ! t��� � 3830 Pllot Knob Road j `� '�?- �� I ' Eagan MN 55122 I Oale Received: i I, Phone:(651)676-5676 j Siaff: I Fax:(651)675•5694 I � � �.�.-.—_____ ��.�.-.___J 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Date:'� SlteAddress; �. i Unit#: (� � Name:V , � Phon : � ResldeYnt/ . � � r . Q°.�`,ner Address/City I Zip: i _;;�: :� ,:,,��.. . Applicant is: Owner ConUactor , '�a'r'�Y�::,�..;: �'r�� 1�^�/ _',v�4.s,r,Y_ �` . �T�/��-�.�: Descriptlan of woAc; Of�VI/�O_[ :: ��" �� • Consfruction Cosk� O� Muiti-Family Building:(Yes�/No� •.�.r-. : . . ..,. Com an 1 ���1 �� f ������L-1 � C �V{ I IC.J p y; ontact 'G�`"'t�ac�Qr. Address:����� I 1Q__� �\1�f City: �� -.°.�. :, _ ..- r � � State:�Zlp-,� Phone: ��mall:l.! S � �� .r��'rl�t Ucense#:���U�'�-t����L� _lead Certlflcate#: IF the project is exempt From lead certificatlon, please explain why: (see Page 3 for additional information) �,\, �, ,.,� . '—,o . I�' �(� �`� � `�� � , � , COMPLETE THIS A A ONLY IF CONSTRUC7ING A NEW BUILDING In the last 12 months,has the Cfty of Eagan Issued a permit for a slmllar pian based on a master plan7 _Yes _No If yes,date and address oF inaster plan: Licensed Plumber: Phone: Mechanlcal Contractor; Phone: Sewer&Water Contraetor: Phone; NOTE:PI'n and s� ,orhn��.. "�ro-'e'"ts'tliat:"oU su t ��" �lonsi' reG(�`o� pu lic InformatJon. Poriions of �t�ie irifo�ai��'�lie cra`ssif��,edt �(,• ^:�rov , s .$t�yould permit ilie-Clty�o , �;,�, •�qn atthQ � � �'�`" CALL BEFORE YOU DIG. Call Gopher 9tste One Call a�(s51)464•0002 for prolectlon agalnsl underground utlllty damage. Cali 46 hours befole you Inlend lo dig to recelue locales of underground ulililles. www.aooherslaleoneca�l.orn �hereby acknoWledge thal thls informalion is coinple(e and accurate;Ihat lhe worlc will be In conFormanCe wilh Ihe ordlnances and codes ol Ihe Clly oF Eagan; Ihal I undersland thls Is nol a permit,but only an BppllcaUon(or a permil,and work Is nol to s1aA withoul a permll; Ihat Ihe work will be(n accordance with the approved plan in lhe Csse of work whlch requires a review and approval oF plsns. Exterinr work autho%Xed by a bullding permlt issued in accordanea wlth the Mlnneeote ate Bullding Code must ba completed within 180 days of parinit Issuance. x�� 1����C�o� x 1 �� Applicant's Printed Name App ca t's Signatu e Page 1 0(3 PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA142542 Date Issued:05/08/2017 Permit Category:ePermit Site Address: 3617 St Francis Way G Lot:039 Block: 05 Addition: St Francis Wood 4th PID:10-65903-05-039 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 - Kimberly K Smith 3617 St Francis Way Unit G Eagan MN 55123--116 Lofgren Heating & Air 5708 Upper 147th St W Suite 106 Apple Valley MN 55124 (952) 431-5811 Applicant/Permitee: Signature Issued By: Signature