EA184848 - Mechanical - Furnace & Air Conditioner - Issued Date 06/26/2023 PERMIT
City of Eagan ® , Permit Type: Mechanical
3830 Pilot Knob Rd ®®°a® ®®;® Permit Number: EA184848
Eagan, MN 55122 ®®®® EAGAN
(651)675-5675 111111111111
www.cityofeagan.com * E R 1 8 4 8 4 8
Date Issued: 6/26/2023
Site Address: 3830 Willow Way
Lot: 57 Block: 01 Addition: Briar Hill 4th
PID:10-14993-01-570
Use: * 10 - 14993 - 0 1 - 570 *
Description:
Sub Type: Furnace&Air Conditioner
Work Type: Replace
Description:
Comments:
Fee Summary: ME-Permit Fee $64.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
Total: $65.00
Contractor: - Applicant _ Owner:
Bathricks Appliances Heather Holm
208 E 2nd St 3830 Willow Way
Hastings MN 55033 Eagan MN 55122
(651)470-4238
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 I
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Permit Fee:
EAGANI
rte= I I
I Date Received: I
3830 PILOT KNOB ROAD I EAGAN,MN 55122-1810 I I
(651)675-56751 FAX: (651)675-5694 I staff: j
Email: buildinginsoectionsc@citvofeagan.com (-----------
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RESIDENTIAL MECHANICAL PERMIT APPLICATION
Date: U-Z6 - 1-3 Site Address: 3$3 O Wt l 100 W�� Unit#:
Applicant is: ❑ Owner R6ntractor
Name: I t'eG��Y� RC)l V-1
Homeowner Address: y v\dpi C AJC,- City: Caf es.
State: f9y zip: S S 1ZZ Phone: mail: Lf o ✓H o�*j efit` a cc L-N
Type of Work —New X RReeplacement _Repair —Alteration —Remove
Description of work:
Y—Furnace _Heat Pump
Description Air Conditioner _Other
Air Exchanger
Company: l?)oZ,\N\% A G`�S D\ �'� I' CContact: E L V
Mechanical Address: 'ZC)!a t5- �` City: 9-
Contractor / c(Jv- Z3 n ^
State:l'`�Zip: �� y
Phone: l9� ��� ` Email: 1 n�d �C IF=S^She C-P. c\6�
License#: n 800436 Expiration Date: O Z LO(,&
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.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 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.
0
XL- X
Applicant's Printed Name Applicant's Signature
FOR OFFICE USE
Required Inspections: Reviewed By: Date:
Underground Rough In Air Test Gas Service Test In-floor Heat Final