1252 Town Centre Dr
For Office Use
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Permit 97S76' City of La afl
Permit Fee: 6 6-0
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3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I
Fax: (651) 675-5694 I Staff: -
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2009 MECHANICAL PERMIT APPLICATION
Date: 5 Site Address: / a ' (CJGcf 1? ~,,E'%~t tr ~L
Tenant: / 6 i- d t-J Suite
RESIDENT I OWNER Name: Phone: L
Address / City/Zip:
CONTRACTOR Name:T~/ License
Address: e (z) r r IC _3h
City: Stat Zip: O
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Phone: Contact Person: _Ieejt:~
TYPE OF WORK New Replacement Addditiona Alteration Demolition
Description of work. lil '-_e- .14 e ! I.tS
NOTE: Both roof mounted and ground mounted mechanical equipment is required to
be screened by City Code. Please contact the Mechanical Inspector or one of the
Planners for information on permitted screening methods.
PERMIT TYPE RESIDENTIAL COMM RCIAL
New Construction
Furnace interior improvement
Air Conditioner Install Piping Processed
Air Exchanger Gas Exterior HVAC Unit
Heat Pump Under / Above ground Tank Install / _ Remove)
**When installing/removing tank(s), call for inspection by Fire
Other Marshal and Plumbing Inspector
RESIDENTIAL FEES:
$50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge)
$90.50 Fire repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) zP_>
TOTAL FEE
COMMERCIAL FEES:
$70.50 Underground tank installation/removal OR Contract Value $ ~y x 1%
$50.50 Minimum includes State Surcharge)
Permit Fee
- If Permit Fee is less than $1,000, surcharge is $.50.
If Permit Fee is > $1,000, surcharge increases by $.50 for each State Surcharge
$1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 surcharge).
$ TOTAL FEE
I hereby acknowledge that this information is complete and accurate; that the work will be in con to ance 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 wit ut permit; that th o will be in accordance with the approved
plan in the case of work which requir s a review and approval of plans.
X <1 -j X
t' Signatur
App icant's Printed Name Appl
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FOR OFFICE USE
Reviewed By: Date:
Required Inspections: -Under Ground - Rough In -Air Test -Gas Service Test `In-floor Heat Final
Exterior HVAC Screening Inspection