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4903 Steeplechase Ct Use BLUE or BLACK Ink r———————— --------� iFor Office Use � ' � Permit#: l l �I � I Clty of�a��� � � �- 3830 Pilot Knob Road � Permit Fee: � � Eagan MN 55122 � I Phone: (651)675-5675 � Date Received: � Fax: (651)675-5694 � I � Staff: � �-----------------� 2015 MECHANICAL PERMIT APPLICATION ❑ Please submit two(2)sets of plans with all commercial applications. Date: Site Address: ��� 3 -ST����r��`��.-- ��' Tenant: Suite#: ��� ;F�.�, � R�S1d�[�tiC�I1E��F�� Name: Phone: ���r� ��� , ��� ..; � �� Address/City/Zip: rb � e 3� � r�,� , � _� ��, �1�� Name:��a („�..a �//Lt�cl„a� ; �..� ?��t�c_.-- License#: � � ,p �° ������,, " � Address:�,�,'-I�l� � j ��lc'a�:7� `�f` �� City: f�'vt c��i/�v' CL���C���C�t'. `; � „ �1,," ' State:` v�l..�- Zip: SS3 c,�c-j Phone: �7G�i— Z�/L— 7��3 .3 �_� � � �� : ` �� Contact: - �� c�._ � S Email: ` � , ���� New Replacement �Additional Alteration Demolition , `'°��7�p��,�W�,�� � � Description of work: /�4��, 1��%� -�-v ;b t�C� ��� ` „�� �� � � 'NE�T� Roc�f�c�u���C and�rc��n�i mour�ted.;rriecM�anical equipm�nt�s v�;q���to be sr�re°��d bjt��#y _ � � �..... � � � ,� �a.� �+�de `A�ease<:c�rnt�ct#he�.I�e�HanMc�!tr�spe�ctar for�nfc�rrr���iol�;r�n�rtn��e�I.s�reening me#1�vds. ` ��.s RESIDENTIAL COMMERCIAL Furnace New Construction Interior Improvement �� mM�T��1� , —Air Conditioner Install Piping Processed � ��� , >.�� � Air Exchanger Gas Exterior HVAC Unit _Heat Pump Under/Above ground Tank �Install/_Remove) �����,....:�• �'� Other RES/DENTIAL FEES $60.00 Minimum Add or alteration to an existing unit, includes State Surcharge $100.00 Residential New, includes State Surcharge =$ TOTAL FEE COMMERCIAL FEES Contract Value$ x.01 $60.00 Permit Fee Minimum, includes State Surcharge $70.00 Underground tank installation/removal =$ Permit Fee "If contract value is GREATER than$2,010, Surcharge=Contract Value x$0.0005 -$ Surcharge" If the project valuation is over$1 million, please call for Surcharge =$ TOTAL FEE 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 ap roved plan in the case of work which requires a review and approval of plans. X � /u c �.�,�I�P� x ApplicanYs Printed Name Applicant's Signature FC�R 4FFI��US� ���;�� � �� ��� � � ����� ' �� ,�F�� � E � �� ��, � � �� ���� �� �'� �F�equired It��pect�vn� ��,���� ������� R�v���r��1 ��'������ G}ate '..: � ,`�. y,�� ;:A\\�C ; �', . yL oy0` ; ,�, yi, � ,.....Untlergrc�un ,;„,;,��ou��h���^ ' =Aic,"Cest .'�r.. Ga��eruice T�st ', `���n t��c�rh�le�t�� . � .: ��nri�I ^,,.,�.HVAC��c�'�ei�ing PERMIT City of Eagan Permit Type:Building Permit Number:EA179784 Date Issued:10/19/2022 Permit Category:ePermit Site Address: 4903 Steeplechase Ct Lot:2 Block: 6 Addition: Steeplechase Of Eagan PID:10-72540-10-043 Use: Description: Sub Type:Reroof Work Type:Replace Description:Includes Skylight Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any repairs must be inspected prior to covering. The inspector will determine if an additional permit will be required to repair the water damage. Valuation: 5,000.00 Fee Summary:BL - Base Fee $5K $118.00 0801.4085 Surcharge - Based on Valuation $5K $2.50 9001.2195 $120.50 Total: This permit shall be null and void if work does not start within 180 days of issuance, or if work is suspended for 180 days or more after started. 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 Heuer 4903 Steeplechase Ct Eagan MN 55122 Parkway Custom Construction Llc 1303 S Frontage Rd Suite 199 Hastings MN 55033 (651) 480-3797 Applicant/Permitee: Signature Issued By: Signature