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3629 St. Francis Way A Use BLUE or BLACK ink � For Office Use j 2 � I Clt of Ea a� � Permit#:��,�,�_,�_ � Y � � � � � Permit Fee:�,Q('� , � 3830 Pilot Knob Road Eagan MN 55122 RECEIVED � Date Received: � `� � � Phone: (651)675-5675 _`— Fax: (651)675-5694 � Staf�J � OCT 0 9 2015 -------------� 2013 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: I��' � ! �� Site Address: ���"'�� -5 l - %��r�lz.��jS� (,�/�� � � Tenant: � ���. � �' ����it� � Suite#: � ' Resident%Owner' Name: -� � Phone: �'�����1�lCv�� � Address/City/Zip:_ (r.a��4`�; /y](v� �S ,�l o��j Name: LCG 3't'26°"I�fi5 �(`f,G Gc.��Ti���'- CU � ����``GA,_.�� License#: Address: `%�.�L' rt� ���� ' ' � Contractor �5�� (`�: ��� City: ��G�"l�� State: � � Zip: r`� 5�`� `� / Phone: ��u -� _��-�,7 T°1 Contact: ���� �-l°'�" � Email: � T � �e�Of�WOf �New _Replacement _Repair _Rebuild Modi S ace yp k .. — — fY p _Work m R.O.W. ' �! Description of work: � e� /I��,c,r,,,� �,���, �, RESIDENTIAL Water Heater Lawn Irri ation �Water Softener Permit T e g �RPZ I_PVB) yp Add Plumbin Fixtures Septic System 8 (___Main/_Lower Level) New Water Turnaround Abandonment RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Water Heater and Softener(includes$5.0o State Surcharge) �v �.. $60.00 LaWn Irrigation (includes$5.00 minimum State Surcharge) ; $60.00 Add Plumbing Fixtures, Septic System Abandonment,Water Turnaround*(includes$5.00 State Surcharge) *Water Turnaround(add$200.00 if a 5/8"meter is required) $105.00 Septic System New($10.00 per as built)(includes County fee and$5.00 State Surcharge) TOTAL FEES$ G����-�C� CALL BEFORE YOU DIG. Call Gopher State One Call at(651j 454-0002 for protection against underground utPlity damage. � / Call 48 hours before you intend to dig to receive locates of underground utilities. www.aooherstateonecall orp � 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 fhe case of work which requires a review and approval of plans. x_ ,�,l�G� �-��T� �' ._ -� . X 0 � ' � �'� �/' ApplicanYs Printed Name Appli�ant s S�gnature FOR OFFICE USE Reviewed By: Date: Required Inspections: _Under Ground Rough-In Air Test Gas Test Final Use BLUE or BLACK Ink ---------, � For Office Use � Cl6 Ol �4 u11 RECEIVED i Permit#: /��7 7� � � � � Permit Fee: (�c�',�`'' � 3830 Pilot Knob Road OCT � 5 20�5 i i Eagan MN 55122 I Date Received: � Phone: (651)675-5675 � � � Staff: � Fax: (651) 675-5694 � I . ��.���������.����.��J 2013 RESIDENTIAL PLUMBING PERMIT APPLICATION �� aate:"��� �e� " ° � �� s�te aadress:_ ��� � �S'i �=.������;fs crd�� Tenant: ��1��:- �,�� Suite#: � ResidentiOwner, ` Name:_ rCJ�i-iJ C y tfd� F� Pnone:_ ���- 1`l'f' ��� Address/City/Zip: ����� � � � � Name:__ C�'��V�'!k`�;�' %l'� � C,�.��'�-�� LG License#: � �����C1,d L Address: l�-5� C c,� �s�" ����C=� C_ �� Contracfor � - �°`� ��"��� ��ty� t3 �j � ' State: ��i AJ Zip: .�� �Y 9 Phone: ��u.� ��--� �-'��°l '� Contact: �--5� �(i�l� EmaiL• T e Of Wo1'k:. �New _Replacement _Repair _Rebuild _Modify Space Work in R.O.W. Yp — 1 Description of work: �� � �e�., �RES ENTIAL ater Heater Water Softener Lawn Irrigation�RPZ/ PVB) Permit Type Add Plumbin Fixtures Main/ Lower Level : Septic System 9 �-- — ) _New . Water Turnaround Abandonment RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Water Heater and Softener(includes�5.00 State Surcharge) $60.00 Lawn Irrlgation (includes$5.00 minimum State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment,Water Turnaround*(includes$5.0o State Surcharge) *Water Turnaround(add$200.00 if a 5/8"meter is required) $105.00 Septic System New($10.00 per as built)(includes County fee and$5.00 State Surcharge) TOTAL FEES$ �•-�� CALL BEFORE YOU DIG. Call Gopher State One Call 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.qopherstafeonecall.org ' 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 approva!of plans. x �l.S��" 1--��-� X _ � ApplicanYs Printed Name A li nt's Signat re , � FOR OFFICE USE Reviewed By: Date: .��� 4 � �rt Required Inspections: _Under Ground Rough-In _Air Test Gas Test Final PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA132994 Date Issued:09/15/2015 Permit Category:ePermit Site Address: 3629 St Francis Way A Lot:007 Block: 04 Addition: St Francis Wood 4th PID:10-65903-04-007 Use: Description: Sub Type:Residential Work Type:Replace Description: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 - Nancy L Hagen 3629 St Francis Way A Eagan MN 55123 (612) 991-1626 Blue Ox Heating & Air Llc 5720 International Pkwy New Hope MN 55428 (612) 238-9709 Applicant/Permitee: Signature Issued By: Signature