EA180875 - Mechanical - Furnace - Issued Date 01/05/2023 PERMIT
City of Eagan Permit Type: Mechanical
3830 Pilot Knob Rd ,��; Permit Number: EA180875
Eagan,MN 55122 '""" ""� EAGAN
(651)675-5675
1111111111111 IN 1111111111111111111111111111111
www.cityofeagan.com * E R 1 8 0 8 7 5 *
Date Issued: 1/5/2023
Site Address: 3750 Blackhawk Rd
Lot: Block: Addition:
PID: 10-18600-00-071 11$11111 1E 11111111111111 Ell 1111111111111111111111111111111 im
Use: * 1 0 — 1 8 6 0 0 — 0 0 — 0 7 1
Description:
Sub Type: Furnace
Work Type: Replace
Description:
Comments:
Fee Summary: ME-Mechanical Residential Alteration $64.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
Total: $65.00
Contractor: - Applicant - Owner:
North State Mechanical Brian E Bolier
16136 Excelsioor Court 3750 Blackhawk Rd
Rosemount MN 55068 Eagan MN 55122
(612)207-0345
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.
ApplicantTermitee: Signature sued 13 : Signature
--------------
I For Office Uro
Fr
Permit 4,' 180873
N l'ean't Fee
EAGA
Hl,,�PILOT KNOB ROAD I EAGAN, MN 55 122-19 10
(651)675-5675 � FAK (651)675-5694
Email: buildirminsnetLons Q –––––––––––––--–
RESIDENTIAL MECHANICAL PERMIT APPLICATION
Date: Sito Addfer,-,. J,
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Applicant is: D Owner "Conlrnr-Jor
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Typo of Work I
Description of work:
Furnace Hoot Pump
Air conditioner Other
_Air Exchancger
Contact:
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Me nic a I City;Pddress:
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State:�\,�� Zip: Phone:�I—X –i( I 1�11-11�1
Expiration Date:
License Pt2J
:
RE S- IDENTtAL FEES
S1r,0,00 New Residential (includes State Surcharge)
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s65,00 Residential alteration,furnace, air conditioner, ductwork,or any combination (includes State Surch
oo.ao Residential fireplace(s)(includes state Surcharge)
TOTAL FEES S
y
by signing tip for an ernail pcjt�on ,,be C,,,�y's�vebsit�,,
I all m n from the City of proposed ordinances
ay ubscrib,to receive an eipctronir notificatio io i�v
.,nlubscribl�. VAtIl the ordinOnce, and ctNItis of t� C
-dq information is compete an 'e in
, ,e, that this inform, 'I e�Qrk
acknowic d accurate; that the viork wi!l bo jn confOFIT),'AnCO
horcuy that I undersl��d this is not a penfill,but only an applicatjon for a permit,and wofk rt to .,t�jrt without a perwit:th,t the'v
in th(, (,.tip approval 1
case of worY v,,Wch requires a r -w and approv, of pkqm,� J
W*Chc approved PXX
Applicant S
pspli'cant's Printed Name
FOR OFFICE USE lzvviowod 11y:
Required InspeelljOrts:
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