759 Cougar Dr Use BLUE or BLACK Ink
For Office Use
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?City of Ea �il
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone: (651)675-5675
Fax: (651)675-5694 Staff:
2017 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit#:
Name: ?ey Lc,,,s� �4 ✓1 rl/cc-- Phone: /.2 bYv 8 2Fx'�7?U
Resident/ /
1 Owner Address/City/Zip: f' ':_)—(1 -/- 7 S C 7 5--"#-'' /,2,
Applicant is: Owner Contractor
Type of Work Description of work: Cot,,.��te. - c..r —v £ c j ter d'vuQ Vic, Loc)e-
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x Construction Cost: g5,V Multi-Family Building: (Yes K /No )
I Company: teFre w kms, _' �. Contact: rJc�f�
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Contractor Address: (lO4 ( it c- 4�� c1(, City: , t41(4 �' ,.•`
State: otiJ Zip: 55?5 Phone:‘---e'a't/9D.)3")6 Email: Adu< to -+u . cc-,—
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License#: 3& g i'1 (:=.5 0 Lead Certificate#:
If the project is exempt from lead certification, please explain why:
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d � �� � � 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:
NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that the are trade secrets.
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.qopherstateonecall.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 State Building Code must be completed within 180
days of permit issuance.
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Applicant's Printed Name Applicant's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA169920
Date Issued:06/15/2021
Permit Category:ePermit
Site Address: 759 Cougar Dr
Lot:132 Block: 01 Addition: Oakwood Heights 2nd
PID:10-53801-01-132
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507)
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 -
Patricia A Larson
759 Cougar Dr
Eagan MN 55123
(612) 702-8408
Prior Lake Heating & A/c
16584 Pebble Brook Ct
Prior Lake MN 55372
(952) 447-8110
Applicant/Permitee: Signature Issued By: Signature