EA181914 - Mechanical - Single Fam - Issued Date 03/27/2023 PERMIT
City of Eagan , , , Permit Type: Mechanical
3830 Pilot Knob Rd ,,�;; �;, Permit Number: EA181914
Eagan,MN 55122 •.-- ••.'
(651)675-5675 EAGAN
www.cityofeagan.com * E R 1 8 1 9 1 4
Date Issued: 3/27/2023
Site Address: 2124 Shale Lane
Lot: 13 Block: 7 Addition: Cedar Grove 4th
PID:10-16703-07-130
Use: * 10 — 16703 - 07 — 130 *
Description:
Sub Type: Single Fam
Work Type: Alteration
Description: Bathroom
Comments:
Fee Summary: ME-Mechanical Residential Alteration $64.00 0801.4088
Surcharge-Fixed $1.00 9001 2195
Total: $65.00
Contractor: Owner: - Applicant -
Valerie Lois Domeier
2124 Shale Lane
Eagan MN 55122
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 ssued B : Signature
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For Office Use
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••• • I l i j Permit#: I
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EAGAN
I Permit Fee:
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Date Received: I
3830 PILOT KNOB ROAD I EAGAN,MN 55122-1810 1 j
(651)675-5675 1 FAX: (651)675-5694 I Staff: 1
Email:buildinoinspections(a-citvofeagan.com 1-----------------'
RESIDENTIAL MECHANICAL PERMIT APPLICATION
Date: 3/23/2023 site Address: 2124 Shale Lane Eagan MN 55122 Unit#:
Applicant is: 0 Owner ❑ Contractor
Name: Patrick & Val Domeier
Homeowner Address: 2124 Shale Lane City: Eagan
state: MN zip: 55122 Phone: 6127152550 Email: paul.domeier.hk@gmail.com
Type of Work _New _Replacement _Repair _Alteration _Remove
Description of work: Basement Finishing
Furnace _Heat Pump
Description Air Conditioner Other
Air Exchanger
Company: Contact:
Mechanical Address: City:
Contractor
State: Zip: Phone: Email:
License#. Expiration Date:
RESIDENTIAL FEES
$150.00 New Residential(includes State Surcharge)
$65.00 Residential alteration,furnace,air conditioner,ductwork,or any combination(includes State Surcharge)
$100.00 Residential fireplace(s)(includes State Surcharge)
TOTAL FEES$
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.cdvofeanan.com/subscdbe.
I hereby acknowledge that this information Is complete and accurate;that the work will be in conformance with the ordina as 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;th the work will be In accordance
with the approved plan In the case of work which requires a review and approval of plans.
XPatrick Domeier X
Applicant's Printed Name Arplicarivwdignabure
FOR OFFICE USE
Required Inspections: Reviewed By: Date:
Underground Rough In Air Test Gas Service Test In floor Heat Final