EA188718 - Mechanical - Ductwork - Issued Date 01/08/2024 PERMIT
City of Eagan Permit Type: Mechanical
3830 Pilot Knob Rd °�° ®� Permit Number: EA188718
EAGAN
Eagan,MN 55122 ���� •�
(651)675-5675 :� ,
111111111111111111111111111111111111111111111111
www.cityofeagan.com * E R 1 8 8 7 1 8 *
Date Issued: 1/8/2024
Site Address: 1273 Interlachen Dr
Lot: 7 Block: 2 Addition: Dakota Path 5th
PID:10-19544-02-070 IBM 1H IN
Use: * 10 - 19544 - 02 070
Description:
Sub Type: Ductwork
Work Type: Alteration
Description: Lower Level Remodel, includes bath fan
Comments:
Fee Summary: ME-Mechanical Residential Alteration $64.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
Total: $65.00
Contractor: Owner: - Applicant -
Uday Sambhara
1273 Interlachen Dr
Eagan MN 55123
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 Issued By: Signature
-----------------
For Office Use I
®� 0 Permit#: 6
1EAGAN ^
Permit Fee: V/
I I
Date Received:
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 j 1
(651)675-5675 1 FAX: (651)675-5694 1 Staff: 1
Email: buildinginspections(c)citvofeagan.com L---------------
RESIDENTIAL MECHANICAL PERMIT APPLICATION
Date: 01/08/2024 Site Address: 1273 interlachen drive, eagan , mn-55123 Unit#:
Applicant is: ® Owner ❑ Contractor
a
Name: Uday Sambhara
a Homeowner Address: City:1273 interlachen drive Eagan
State: MN Zip: 55123 Phone: 408.203.5355 Email: uday.sambhara@gmail.com
Type of Work _New _Replacement _Repair ✓ Alteration _Remove
Description of work:
_Furnace _Heat Pump
Description _Air Conditioner Y/ Other HVAC extensioel
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.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. `
XUday Samhara XUday Sambhara Date:l024.01dbyudaysambhara
J Date:2024.01.08 11:28:36-06'00'
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