EA179993 - Mechanical - Furnace & Air Conditioner - Issued Date 11/07/2022 PERMIT
City of Eagan P Permit Type: Mechanical
3830 Pilot Knob Rd ,°.; �p'�• Permit Number: EA179993
Eagan,MN 55122 .--- =-•• E A A N
(651)675-5675 111111111111
www.cityofeagan.com E R 1 7 9 9 9 3
Date Issued: 11/7/2022
Site Address: 1025 Diffley Rd
Lot: 2 Block: 1 Addition: Kirchner Plaza
PID: 10-42100-01-020
Use: * 10 - 42 100 - 0 1 - 020 *
Description:
Sub Type: Furnace&Air Conditioner
Work Type: Replace
Description: replace radiant heat with forced air
Comments:
Fee Summary: ME-Permit Fee(Replacements) $59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
Total: $60.00
Contractor: Owner: - Applicant -
Samuel W&Melba R Johnson
1025 Diffley Rd
Saint Paul MN 55123-450
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.
Applicant/Permitee: Signature sued B . Signature
---------------- ,
1
For Office Use I
�� i iI SII 1 Permit#: 179993
• ,. . I I
•� �� 1 Permit Fee: $60 1
�^ -EAGAN
ECEIVEI 1
I Date Received: I
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 I I
(651)675-5675 1 FAX: (651)675-5694 ®CT 3 1 2022 1 Staff: I
I
Email:buildinginsoectionsO—citvofeanan.com -----------------J
BY:
2022 RESIDENTIAL MECHANICAL PERMIT APPLICATION
Date: C a 11 ?X Site Address: I G �,5 �,-Fif'ley got 6 fjq m m n Ss 12 3
Tenant: Suite M
•`t" Name: Rq y4 G'h at k T awsle j Phone: Ki y 7a 07 CIC
Address/City/Zip: f'a 01' q S-1-LZI
Name: !V ,i- License#:
' Address: City:
` State: Zlp: Phone:
Contact: Email:
i .
RESIDENTIAL
F C Furnace
" X Air Conditioner
Air Exchanger
Heat Pump
5 y Other
X New Replacement Additional Alteration Demolition
Description of work: (`PWl(�1'A17 — mA� W l-fGl YIPo( a/
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 small update on the City's website at
www.cltvofeenan.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 plan in the case of work which requires a review and approval of plans.
X ROlmanoL .- T
Applicant's Printed Name Applicant's Signature
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