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1863 Cliff Lake Ct Oct 07 2014 0826AM HP Fax page 13 Use BIUE or BLACK Ink �----------------, � For Ottice Uae � • i � �.,��,o(�� i Clty of�a�a� � Permit#: � � Perm it Fee: � i�•� � 3830 Pllot Knob Road � � Eagan MN 55122 � Date Received: � Phone:(651)675-5675 I I Fax:(651)675-5694 I Staff: I I I L�....��`_______J ,� 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Date� r'�'.� � Slte Address• 1�S� ! � � l, / '� l 3i ��G 5'G�,� �a,�� r unit�: Name: �..7 i`'� ��'=::. ��'`�� f�: �''� v�,. Phone: ResidenU Owner Address/City!Zip:��9'Y!� C� Applicant is: Owner �°`� Contractor -- ,� Description of work: � �° '.c,.� a�'�� --'1 Type of Wcrk I, : Construction Cost: 3 ?S�'Z'�G. `..� Multi-Family Building: (Yes �/No_� ,.- ,,r' y -�°° 1 Company,�'�%��;��u��'Z�2''�✓'��x�: Contact: !,'�,�.�yi.F,`;��;,,.< '. : , .._ ..,�. ,r-�,_, Contractor Address',��c@ v`r2� s��,.;-�; ��.� �:�r�.-��°��s�:.� city: �s��+��t��,� State��`��'° Zip: .�`� G • Phone:�.( •`j`'' �&'',�(�' )��Emell: ?t�.�G..'��' ' �f��°%' � .�.,�;t�:T�tca .._.ra;^,�.�r}��s.�i. ';�„ • � /e� , � �� License#: ,�',��e�r�� r�i"l Lead Certiflcate#: •�� a-'`=�'"� ' f If the project is exempt frorn lead certlflcation, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUiLDING In the lasi 12 morrths,has the Clty ot Eagan i�sued a permit for a slmllar plan based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer&Water Contractor: Phone: NOTE:P/ans and supportirtg documents thai you subm/t are considered fo be pub/ic intormation. Portlons of the informatlon may be classJf/ed as non pubtic if you provide specific r+easons tfrat wou/d perm/f ihe City to conc/ude fhat!he are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at(651 454-0002 for rolection against underground utility damage. Call 48 hours before you intend to dig to receive locates oi underground utilities. www. o hersta;eonecall ur I hereby acknowledge that this information is complete and accurate; that the wo�k will be in canformance with the ordinances and codes ofthe 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; thet the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterlor a-agthorized by a bullding permlt Issued tn accordance wNh the Minnesota State 8ullding Code must completed wlthln 180 da perml�suance. �,_,,...-----:-.:.°.�= F�- ¢�! "�- `� � � '�f,� x � �..-- ��.�`/ X - �'_:_..�+:_,.. - Applicant's Printed Name Applicant's Signature i Page t ot 3 Use BLUE or BLACK Ink r----------------,--� 1 For Office Use � � j .� �1 � �� o� �� j Permit#: � � � ' �s� ' � Permit Fee: � 3830 Pilot Knob Road � � Eagan MN 55122 � Date Received: � Phone: (651)675-5675 f ��^ I � Fax: (651)675-5694 ( � i Staff: I -----------------� 2015 RESIDENTIAL UILDING PERMIT APPLICATIO�� S� Zz . �r� // Date: �� 1� �S Site Address: �lr �� ""^c �p� � Unit#: g�,�.,...�.�,�....�.,,.,��_ ..�, _.,�.,..�. .,..�u.�........_,� .,...��.�.,.....� ,�,m.x.,��.,.�w.._.w,_n��,.._�,b.,.�..,.��,�...,.�,.n,..� � �.- ...a.�...�...._..,.�.�.,w...._..�..�,...�._ �, _ ._, 7 , z � � tVame: ��l�� (�G j�!.o✓C.,S Phone: � � �ES��S�� ; # � ��gr � Address/City/Zip: .��; � k � �.� � � Applicant is�,.....��,da� Owner ..�x.....w. Contractor� �..��_.��,.�...��..�.�.��..,,.,..w,e,��._...�... _�.._. ,.,�.....�� M�... ,,�...�µti...�,., ..�.�.... , �� Description ofwork: W�� T� c�f W�rl� � � � Construction Cost: Multi-Family Building: (Yes /No� � �s_.. _ ..., .,..�.�,...�..�,�:,,.,,�_:_...,.......,,..�,.�,.:-�..:�...�_..,.�.aa....�....�,.-a.�..�..�.�._.....�:.:,.�...,.�.�,.�...�. ....��,....�,..�..,�,.,.�.I ��. �-y---� ...,�,.�...,�.....�,..g � �� Company: J t-� h�� G�o1� �h�, Contact: /-�` f Y�t u� � � � � �� Address:_JSO-b �'�.��Jw�� G�/� � Suf e �.s/ City: % � Con�tractr�r � � SSy�� { State: Zip: Phone: ��3-SSU.Gn'�� Email: ��J � �atn�.I��uy��`�J•� � � £ ' � License# �G �� 1�.3 Lead Certificate# � ��, �µ��m�,��a_,��.�a�...�.,...�,.�.w„w,�.....,�... -�,..�, �,,._..... �,__...�,�..,,v,�..,.��,..m,�� ,..�,��.�� ., �,u.,x ��,.,.��,.�.,. .�.�.,,��,_..�.,,��.�.,.,�.,�,....�,�,��....�,,�..<... � � If the project is exempt from lead certification, please explain why: � - �,,...,�n.,.._.��..�._�.�.�.. ... ... �m._��.�..r��,��.....�_.Aw��.....,.�_�..��...,...�,.,.. ,.m..�...�.W...��. -- _�_��., COMPLETE THIS AREA ONLY I� CONSTRUCTiNG A NEW BUILDING � � � In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? � # � Yes No If yes, date and address of master plan: � � � � � Licensed Plumber: Phone: � Mechanical Contractor: Phone: � Sewer&Water Contractor: Phone: � Fire Suppression Contractor: Phone: �IV�Tf.P�l��r�st�vc��i�g dnct��ra�th�,�o�►s��e caa��a��red i�bE��b��. Po�o�s af � � ��e i��'orr�a��r�,�r,��classs�ed as non-}��6��y��Fro��s�ec�c rea�+a�s tha,��fr�C��t�a � �.: ec�;n�l��1e i��st t��r a�t�°a�ll�s�c�e#s> - � CALL BEFORE YOU DIG. Call Gopher State One Cafl at(651)454-0002 for protection against underground utility damage. Call 48 hours before 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 accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota S t Building Code must be completed within 180 days of permit issuance. '/ `�..-.^-� x �u�f T ro ��.�--� x e Applicant's Printed Name Appli s Sign ture Page 1 of 3 PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA176580 Date Issued:05/23/2022 Permit Category:ePermit Site Address: 1863 Cliff Lake Ct Lot:20 Block: 01 Addition: Cliff Lake Shores PID:10-17785-01-200 Use: Description: Sub Type:Air Conditioner Work Type:Replace Description: 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 - Mary L Bongard 1863 Cliff Lake Ct Eagan MN 55122--247 Haley Comfort Systems 3708 Broadway Ave N Rochester MN 55906 (507) 281-0138 Applicant/Permitee: Signature Issued By: Signature