unit 202 For Office Use
For
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0 -Fee:EAGAN
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3830 PILOT KNOB ROAD l EAGAN, MN 55122-1810 Date Received:
(651)675-5675 l TDD: (651)454-8535 I FAX:(651)675-5694
Email: buildinginspections(a'7cityofeagan.com Staff:
Commercial Plan Submittal:eplans a citvofeagan.cam L,_ J
2019 RESIDENTIAL MECHANICAL PERMIT APPLICATION
,
Date:
3i~ c'i % Site Address: 1520 Thomas Lake Pt Rd c 1-'
Suite#: 20.4.-J
Tenant:
c141 4, : 763-231-5280
k ' 71� Nationwide Housing Corp Phone:
� ���� � eName:
Resldeln#!, P 6200 Shingle Creek Pkwy #300
°-",,,--",,,:,',.,1,4:4;.:4",..A1,,, ,'� ' o; Address/City!Zip.
- 7,! B003401
, , , Name: Heating & Cooling Two, Inc.lncLicense#:
a N �� x, Address: 18550 Cty Rd 81 city: Maple Grove
�_ Add
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A 3 MN 55369 763-428-3677
.. „. State: Zip: Phone:
M contact: Linda Locke Emaii: permit@heatcoo12.com
iii i � : RESIDENTIAL
,W ` Furnace
4
Air Conditioner
ce
Air Exchanger
, ., Heat Pump
y ^" other
New / Replacement Additional Alteration Demolition
E,..'.:--‘1,,,,,,,,1-41-14,4,,,,,:-",,,,714.0.1-
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,_ R Description of work: ,'C ��( (r��' / �!%• ( i i .:-
RESIDENTIAL FEES
$60.00 Minimum Add or alteration to an existing unit,includes State Surcharge
$100.00 Residential New, includes State Surcharge =$ TOTAL FEE
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.citvofeagan.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 penftrt, 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 whlc requires review and apprgwal of plans.
XLinda Locke ; _X �. It.�`
Applicant's Printed Name Appli nt's Signature
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