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874 Trails End Rd Use BLUE or BLACK Ink r----------------- I For Office Use I I I Permit#: City of Ea�ai� Permit Fee: 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: Phone:(651)675-5675 I I Fax:(651)675-5694 I Staff: I I I 2016 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: ' 7 Unit#: `..1 Name: �1 c ✓1 �� ,ti* ri Phone: 'i 2 Address City/Zi p' Applicant is: Owner ontractor SWork; Description of work: T << Construction Cost: U-b C) Multi-Family Building:(Yes /No Company: Contact: Contra Address: City: State: Zip: Phone: Email: ..° License#: Lead Certificate#: If the project is exempt from lead certification, please explain why: COMPLETE THIS AREA ONLY IF 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: of su o d at bm n5derli+c . on ; w ffil a r� c �o� d sops d pe ea Winch a That fs , 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.cior)herstateoliecall.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, z nd 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 State uilding Code must be completed within 180 days of permit issuance. �y y x Lr �1A< r RSA ,;f4 i ` Applicant's Printed Name Applicant's Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA143821 Date Issued:06/28/2017 Permit Category:ePermit Site Address: 874 Trails End Rd Lot:000 Block: 001 Addition: Wescott Hills 5th PID:10-83602-01-031 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 - Star Management Llc 2027 Safari Hts Eagan MN 55122 Air Express Inc 1010 - 118th Ave NE Blaine MN 55434 (763) 291-8519 Applicant/Permitee: Signature Issued By: Signature