3569 Blue Jay Way Unit 103 a i � � For Office Use
} E® � Permit#:
`" Permit Fee: L
Date Received:
3830 PILOT KNOB ROAD l EAGAN,MN 55122-1810
(651)675-5675 l TDD:(651)454-8535 I FAX: (651)675-5694 Staff:
buildinginsnections@citvofeaaan.com L
2018 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: i2 I Site Address: 35-7 T EZieJaty1 A9' IA4 5/;23
Tenant: said 41,4 a VC, Suite#: ' 10
Resident/Owner Name liceih!ca /7 3 f vPr Phone: 745---7 9O
Address/City/Zip:;55709 f! „la U' Al, 5ZS7s 5 4e-
Name: Srti a �yY �G 4i LLC. License#: Pc-73?2-57
(
Address: 97o/ '4 SGL AVE City: AThr7Z/77‘'
Contractor / C�17‘00--9/ 5--.
State: MA Zip:;r$3 O/ Phone: 7 '3"
Contact: .4 I an 4 !/Sf Email: 1 ,i" /' C -L .
Type of Work
New 1 Replacement _Repair _Rebuild Modify Space _Work in R.O.W.
Description of work:
RESIDENTIAL
yWater Heater
Water Softener
Lawn Irrigation(_RPZ/_PVB)
Permit Type
Add Plumbing Fixtures( Main/_Lower Level)
Septic System
New Water Turnaround
Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater,Water Softener, or Water Heater and Softener(includes State Surcharge)
$60.00 Lawn Irrigation(includes State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment,Water Turnaround*(includes State Surcharge)
*Water Turnaround(add$280.00 if a 3/4"meter is required)
I $115.00 Septic System New(includes County fee and State Surcharge) TOTAL FEES$ &t cit
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Cali 48 hours before you
intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.citvofeaaan.com/subscribe.
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,planplin the case of work which requires a review and approval of plans.
cwi
ell x AIK-&-45-",";,"•-
Applicant's Printed Name Ap•'want s r s nature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Rough-In Air Test Gas Test Final
Meter Related Items: Meter Size Radio Read Manometer Staff:
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA165102
Date Issued:10/19/2020
Permit Category:ePermit
Site Address: 3569 Blue Jay Way 103
Lot:217 Block: 04 Addition: Lexington Place 2nd
PID:10-45051-04-217
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
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:
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 -
Kathryn E & Frances E Biver
3569 Blue Jay Way Unit 103
Eagan MN 55123
Renewal Andersen
1920 County Road C West
Roseville MN 55113
(651) 264-4777
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA179262
Date Issued:09/26/2022
Permit Category:ePermit
Site Address: 3569 Blue Jay Way 103
Lot:217 Block: 04 Addition: Lexington Place 2nd
PID:10-45051-04-217
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
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 -
Frances E Camilo
3569 Blue Jay Way Unit 103
Eagan MN 55123
Renewal Andersen
1920 County Road C West
Roseville MN 55113
(651) 264-7052
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA179860
Date Issued:10/24/2022
Permit Category:ePermit
Site Address: 3569 Blue Jay Way 103
Lot:217 Block: 04 Addition: Lexington Place 2nd
PID:10-45051-04-217
Use:
Description:
Sub Type:Furnace
Work Type:Replace
Description:
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:
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 -
Frances E Camilo
3569 Blue Jay Way Unit 103
Eagan MN 55123
Schwantes Heating
6080 Oren Ave N
Stillwater MN 55082
(651) 439-3331
Applicant/Permitee: Signature Issued By: Signature