1866 Jade Lane
Use BLUE or BLACK Ink
For office Usei
I
I
I Permit#: / Dtl I C~
City o Eapn Permit Fee: ~tJ CJ 1
3830 Pilot Knob Road 1
Eagan MN 55122 i Date Received: 1
staff.
Phone: (651) 675-56TS 1
Fax: (651) 675-5694
INFLOW INFILTRATION PERMIT APPLICATION
Piurnbing 1 Sewer & Water
Dater r r Site Address: O t`? CAL
Tenant: ) cilL Cr~t dSS- Suite
t
^,:i ~j 3-mss
Name: Phone:
RESIDENT 1 OWNER /
j Address ! City 1 Zip:
Name: V,(-? Lo 0"It, License a
a
~~(r( 4ti. q ( /
Address. `-1. ~f 0 S`~ 5 city: t` f U<-C.~r'` (C y
CONTRACTOR
ll
5 i
L
State /V Zip: Phone: G
;
I
g [
k contact a r1 Email: t
PLUMBING (Within the building envelope) SEWER 8 WATER (Outside the building envelope)
TYPE OF WORK tSump Pump Repair Repair y
I~ ? r
ti Other: Other
I (
I Description of work:
DESCRIPTION
e l
1
a L X
-d C'
FEES
$55.00 f Each (includes $5.00 State Surcharge) TOTAL FEE $
*Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit III repair costs for
reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors
can be found by visiting www.ciNofeaaan.com/infiow, or City Hall at 3830 Pilot Knob Rd.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0402 for protection against underground utility damage. Call
46 hours before you intend to dig to receive locates of underground utilities. www.oooherstateonecall.org
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 a plication for permit, and work is not to start without a
permit; that the work will be in accordance with the approved plan in the ;Ilcan rk which r uires a rev' nd approval of plans.
Appficant's Printed Name Ignatwe
FOR OFFICE USE Reviewed By: Date:
I.•d LZLZ-Sb9-OZ£ J1H 'R nfl d ~:13AI2J MOJO e69:g0 L i. 86 Inf
FPERMIT
CITY OF EAGAN
3795 Pilot Knob Road Eagan, MN 55122 N2 4272
PHONE: 454-81 00 i
s-
? v <:; w II
?. '?_-tli,e Receipt # I
Dnte 19 7 7 I
Site Address ° °`''" `'"
Lot Block 5? Sec/Su6. ['r ?
Parcel #
c: Nome Dc-?='L2 (-?f?r?-??Tn
3 Address %$bfi J;:_dG l..n
? City Phone f?54-3Q25
?
O
"
hlame : - -•: .,.t'?s, ?
`? 4nk'? cABBt
? „
¦
F-
oU Address 13r. _ Assessment
529•6172 Water & Sew.
Address
I hereby acknowledge that I have read this application and st
the information is correct ond ogree to comply with o!I ap
Stote of Minnesoto Statutes ond City of Eogon Ordinances.
Signature of Permittee
A Building Permit is issu
oll work shafl be done ir
Building Official
i Police
Fire
Eng.
P4anner
Council
ate that gldg. Off,
plicable
APC
Fees
Permit
Surchnrge • -?`'li
Plan check I
SAC
Water Conn. ?
Woter Meter
.?Y _.
TOtOi r-
I
to: j'eni? 'ior tor- or, the express condition that
:cordonce with all applicable Stete of Nlinnesato Stotutes and City of Eacon Ordinances.
EreCt [R OcCUpancy
Alter
? ?
Zonin-j
Repair ? Fire Zone
Enlorge ? Type of Const. ?
Move ? # Stories M
Demolish ? Front ft. ;
Grade I-I Depth ft. ;?
PamIY # DaM Inuad ParMltt"
Plumbing
Mechanicol
INSPECTIONS DATp INSP. Rough-In Finol
Footings 7 bate Insp. Dcte Inap.
Foundotion Plumbing
Frnme/ins. Meciwnical
Final =-2 ?
Remarks:
CITY OF EAGAN
Addition CEDAR GROVE #7 Lot- 3 eik 5 Parcel 10 16706 030 05
Owner `street _1866 Jade Lane scace Eaqan, NIId 55122
improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRAOING
SAN SEW TRUNK 5' 1970 $8.18 2.08 28 Paid
* SEWER LATERAL 1971 20
WATERMAIN
* WATERLATERAL 1971 1,615.00 $0.75 20 Paid
WATER AREA
* STORM SEW TRK 1971 20
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STAEET LIGHT
WATER CONN, 260.00 3257 2-22-71
BUILDING PER,
SAC 200.00 -49
57 22-22-71
,
EAGAN TOWNSHIP
BUILDING PERMIT
Ownes -??./ ?O '
.....""...- - -D----- ......... ./...?...-...-°-...--......_--.-'.._......._.....
Address (PIeseni) _ ...........................
Buildar ....
Addracs ..
No 2388
Eagan Township
Town Hall
n8:e .....................
Slozias To Se Used For Fron! Deplh Heigh} Esf. Cos! Permit Fee Remarks
l
LOCATION ?
or
.3 3
This pesmit does not sulhoriae the use of sireels, roads, alleys ox sidewelks nar does it give the owaer or his agea!
the righ! !o cseate any sifvaYion which is a nuisance or which presenis a hasard !o the heallh, safely, canvenience and
general welfare fo anpone in the eommunify:
THIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WOAK IS IN PAOGRES .?
Th[s is fo cerlifp. Shal...C ...... ....
lt? ...... .'-...... ..'.j..^..`_.°?--has permission !o esec! a.c?. ... >of _. .._upoa
.... - ?--- ----- ?-??---?--...--•---- - -.--......
the above desaribed premise subjee! !o the provisions of the Building Ordinanae for £agan Tawnship a opled Apsil 11,
1965.
--°.--°°---........`.':.`..,.".' ....................... Per ------------------- .....`.C............CT...........u._............................. --...--._..
Chairdian of Tnwn $oard ? Buildin Ieu eclor
?i
a.
EAGAN TOWNSHIP
BUILDING PERMIT 10 2556
./
Owne: Eagan Township
Addsess (P sen .......... ........t'+':t?. Towa HaA .
Buildet ................ ........... ....------ --------------- .
Det. .
Addrese ...-.......... ....--------------- -------- ........................_.........................
SSOSies To Be Used Fos Fsonf Deplh Haigh! Esf. Cos! Permil?Fee
l Remasice
?i?//? ?.- ?-7 ? ? ?S? ?i
LOCATION ,?? L ,
Sfseel. Road or olher Descrip!!on of LocalSon I Lo! Block Addilion os Trao!
1lfL LaU'z ?vs?,nr? l V J l-• l' 7 .
L
This perm does not au3harisa the uae of elreeie, roads, allepa ar sidewalks nor doas it give the owner or hia agen!
the right to crea2e any sifuation which is a nuisance or whiah presents a hazard io the healYh, safely, eonvenienee aad
general welfare !o anyone in the communify.
THIS PERMIT MUST BE EP ON/fHE,? PREMISE WHILE THE WORK IS SN PROGRESS.
This is !a :
eeslifp, fhai ?....... ... ........haspermission fo erect
the a6ave deecsibed pre ise subjec! !o the provisions of the Suildinq Ordinance fos Ea an Township ad !ed Apr11 11,
19b5. ? ? ?? _
...... ...Q?jr.L_..:s..-,?...^..c.....----°-°---.._--.. ................ .:. ?...._...P........:.
.....:........"-""'--
airman of Tnwn oerd BuSldin Ins ecior
B
? .?
,3 -S= 7
C, G.
TOWN OF EAGAli
3795 Pilot Knab F.oad
St. Paui, Minn. 55111
PERMIT N0. 86.
The Board of Supervisors hereby grants tcCedar 8rove Construetion Co.
of 7343 Cdncord Blvd. E„ So. St. Paul 55075 a PLUMBING
Permit £or:.. (Owner) Cedar Grove Construction ar 1866 .Iade Lane d. 4061 v..m,_.. .___,
, pursuant to application datad February 17, 1971 ,
Fee;Paid: $40,00 Dated this 22nd day of February ? 1971
Building Inspector
3-5-7
.
TOWN OF EAGAN
3795 Pilot Knob P.oad
St. Paul, Minn. 55111
PERMIT N0. 78
The Board of Supervisors hereby grants to Cedar Grove Construction Co.
of 7343 Concord Blvd. E. So. St. Paul 55075 a HEATING
3-5-7 3-3-7 ?
Pezmit for; (Owner) Cedar Grove Construction at 1866 Jade Lane d 4061 Pumice Lane
, pursuant to application dated February 17, 1971 ,
Fee Paid: $40,00 Dated this 22ad day of February _, 19 71,.
Building Inspector
/
CITY OF EAGAN
3795 Piloe Knob Rood Eagan, MN 55742
' PHONE: ?5700
BUILDING PERMIT APPLICATION F"a :.5w Receipt ?
N9 4272
5668
To be used for Fpnce pate April 15, 19 7 1
Site Address 1866 Jade Ln Erect [k Occuponcy
-
Lot-IBlock$. _ Sec/Sub. E(`, ? Alter ? Zoning
Porcel # Repair ? Fire Zone _
Enlorge ? Type of Const.
rc Name Dean Horton Move ? .# Stories
z Address 1866 Jade Ln
Demolish ?
Front ft.
Ciry E8gan phone 454-302 5 Grade ? Deorh tr.
e__.....i. Cm.
o Nome - SI'.*..i.ng Feas a,..,?,.d roo,?,...st. Se:
?? Address 5222 Minna qna Dr_
I- .-:•_ Mnlc_ n?--- 579-6172
Name _
Address
I hereby acknowledge that I have read this opplicotion and state that
the information is correct and ogree to comply with all applicable
SMte of Minnewta Statutes and City of Eagan Ordinonces.
Signature of Permittee -
A Building Permit is issue to: __Re
all work shall be done cordan with
Building Official
Assessment -
Water $ $eW.
Police
Fire
Eng.
Plonner _
Council -
Bldg. Off. -
APC
Permit J•vV _
Surchorge .50
Plan check_
SAC
Woter Conn.
Water Meter
Total 5.50
_ on the express condition that
nnd City of Eagan Ordinances.
EAGF.N TOWN5HIP
3795 Pilot Knob Road
St. Pau1, Mianesota 55111
Telephone 454-5242
PERMIT FOR WATER SERVICE CONNECTTON
Date: February 17, 1971 Number: 544
3-5-7
B111ing P1ame: Cedar Grove Const. Co. Site Addreas: 1866 Jade Lane
Owner: Same
Pltmber; Stein, Inc.
er
Billing Addxess 7343 Concord Blvd. E.
South St. Paul, Minn.
55075
ze +Connection Chg.260.00 ud 2/22/71
Meter No, +Permit Fee 10.00 nd 2/22/71
Meter Reading IMeter Dep.
Meter Sealed: Yea_ 'Add'1 Chg.
NO f Total Chg
Building is a:
Residence ?
Iqultiple tio, Units
Commercial
Ixttlus tria 1
Other
Inspected by
Date
Remarks:
1i54°ROPFRLY INSTALLED ilJ?FTCRS.
B9,
Chief Inspector
In consideration of the issue and delivery to me of the above permit, I
hereby agree to do tte proposed work in accordance with the rules and
regulatioas of Sagan Township, DakoCa County, Mfnnesota.
By: CRnAU f:uOVE COf1STRlCITON COA1PLNY
Please notify the above office when ready for inspection and connecYion.
EAGAN TOWNSHIP
3795 Pi1ot Knob Road
St, Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR SEWER SBRVICE CONNECTION
DATE: February 17, 1971 NUMER 703
(Lot 3, Block 5, Cedar Grove #7)
OWNER•CEDAR GROVE CONST. C0. Addxess 1866 Jade Lane
?
PLUMBER Stein, Inc. Try[pE OF PIPE Cast Iron
DESCRIPTION OF BUI1A ING
Industrial Commercial Residential Multiple Dwelling No. of units
?ooc
Location of Connectioas:
Connection Charge 200.00 pd 2/22/71
Permit Fee 10.00 pd 2/22/71
Street Repairs
Total
Inspected by:
Date
Remarka•
By.
Chief Inspector
In consideratioa of the issue and delivery to me of the above pezmiC, I
hereby agree to do the proposed work in accordance with the rules and
regulationa of Eagan Totrnship, Dakota CouaCy, Minaeaota
By. CEDAR GROVE CONSTRUCTION COMPANY
YVlOY(Dn..O ') E
Please aotify mhen ready for inspection and cosmectioa and before an portioa
of the work ie covered.
MASTER CARD
6
LOCATION
OWNER K Aqo%AMJ
STRUCTURE AND ?A R
LAND USED AS
-? -
Permit
No.
Issued Issued To
Goniractor Owner
BUILDING
PLUMBING
?
I
-
V -?G
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
HEATING
GAS INSTALLING
SANITARY SEWER I
OTHER _ I
OTHER I
r 1
LJ
r ?
?
Items Approved
(Initial)
Date
Remarks
Distance Fr5? Wel?
FGOTING /n 9-,23- r SEPTIC ?
FOUNDATION CESSPOOL
FRAMING s? ? 7
Cpe •
TIIE FIELD FT.
FINAL
ELECTRICAL
HEATING DEPTH
OF WELL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING I
WELL
SANITARY SEWER
Violations Noted
on Back
COMMENTS: 7 I ?
Ill .Qt _
w
0
lo
.
? ; o/ `?t?
? y
?
L 997 +?- c
alaa j+ 99A/ ?1 /
?
? * tl
a
MASTER CARD
• LOCATION V Oi
OWNER
SiRUCTURE AND
LAND USED AS ?
?
'4`G 3
• '7
Permit I No. Issued Coniractor Owner
BUILDING
PWMBING
CESSPOOL - SEPTIC TANK .
WELL
ELECTRICAL
HEATING 79
-
GAS INSTALLWG I
SANITARY SEWER 7
P3
OTHER -
OTHER I
•
?
Items Approved
(Inifial)
Dafe
Remarks
Distance From Well
FUOTING SEPTIC
FOUNDATION CESSPOOL
FRAMING TILE fIELD FT.
FINAL
ELECTRICAL
HEATING DEPTH
OF WELL
GAS INSTALLATION
I
SEPTIC TANK
CESSPOOL
DRAINFlEID
PLUMBING ?
4`
WELL
SANITARY SEWERd
I?
h
_ Vio!ations Noted
on Back
COMMENTS:
JAN-23-2012 12:16 PM STANDARD WATER CONTROL 763 537 1882 P.01
• lilt j Ul DdEdll -~h
I Permit Fee: ~r y I
3850 Pilot Knob Road
Eagan MN 68122 RECEIVED I Date Received;
' I
Phone (661) 675.8876 i Staff;
Fax: (651) 675-5604 JAN l 3 2012 1 t
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: ' oc Site Address: Unit
1f:fi n p H i !9 f
Name: I r 0 Phone:
Aat~~~
Address/City/Zip: 18GG ~e_ ~.n fwotaan, M1 ~5~~a
111i~1.~+:.~i~~ a~. a
Applicant Is: Owner Contractor
r Dsscriptlon of work: r 1 h l /Q SU : ,p m
Construction Cost:
6,4044191 Multi-Family Building: (Yes / No__)
d} 's 41K;j~`,,.-l` Company /r k f0 contact: Ale 04"n
y' Address: City
•sri~tState:.Md~ Zip: 7 Phone: 9
r.- 0
~ ^~lr• License Lead Certificate tite
If the project Is exempt from lead certMostlon, please explain why: (see Page 3 for additional Information)
COMPLETE THIS AREA 2= IF CONNSIRUCTING A W& BUILDING
In the last 12 months, has the City of Eagan Issued a permit for a similar plan based on a master plan?
Yss ,_•,_No If yea, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer A Water Contractor: Phone:
CALL BEFORE YQU DIG, Cali gopher stets One Call at (061) 4644002 for protection against underground utility damage. Call 48 hours
before you Intend to dlg to receive locates of underground utilities, www.aooherstala risIQs l.orn
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.
Exterior work authorized by ■ building permit Issued In accordance with the Minnesota State Building Code must be completed within I60
days of permit Issuance.
x
A aan 's PlInted anti App eaM's t re
Page I of
• DO NOT WRITE BELOW THIS LINE
SUB TYPES
_ Foundation _ Fireplace _ Porch (3-Season) _ Storm Damage
Single Family _ Garage _ Porch (4-Season) _ Exterior Alteration (Single Family)
_ Multi _ Deck _ Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi)
_ 01 of Plex Lower Level Pool Miscellaneous
Accessory Building
le,
WORK TYPES
New _ Interior Improvement _ Siding _ Demolish Building*
_ Addition _ Move Building _ Reroof _ Demolish Interior
Alteration _ Fire Repair _ Windows _ Demolish Foundation
Replace _ Repair _ Egress Window _ Water Damage
Retaining Wall *Demolition of entire building - give PCA handout to applicant
DESCRIPTION
Valuation Occupancy MACES System
Plan Review Code Edition SAC Units
(25%_ 100%) Zoning City Water
Census Code Stories Booster Pump
# of Units Square Feet PRV
# of Buildings Length Fire Sprinklers
Type of Construction ~r Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final / C.O. Required
Footings (Addition) 1 Final / No C.O. Required
Foundation t✓ HVAC _ Gas Service Test Gas Line Air Test
Drain Tile--- ~00 Other:
Roof: -Ice & ater -Final Pool: -Footings Air/Gas Tests -Final
Framing Siding: -Stucco Lath -Stone Lath -Brick
Fireplace: -Rough In -Air Test -Final Windows
Insulation Retaining Wall: _ Footings _ Backfill _ Final
Sheathing Radon Control
Sheetrock Erosion Control
Reviewed By: 100 , Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge 0
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2of3
Use BLUE or BLACK Ink
1 For Office Use I
City of Ea on I Permit# o'~)
1
I I
Ed 1
3830 Pilot Knob Road Permit Fee:' I~
Eagan MN 55122 RECEIVED I Date Received:
Phone: (651) 675-5675 1
Fax: (651) 675-5694 JAN 3 1 2012 Staff:
L---------
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
Date Site Address: JJA /
E--- ~ Unit
Name: SU t Itit Ec,) SSA tst2~5~ Phone: _ ~S(~ ZOb -x}34 7
RESIDENT / i
OWNER ~j Address / City / Zip: 1966 s'`aD4e (.._N 5A-<y AA f /yq M SS12.7-
Applicant is: Owner Contractor
TYPE OF WORK FDescriptionof work: t T
Construction Cost: Multi-Family Building: (Yes _ / No )
j
Company: RTS it OaE-LI 6- I.C.C. Contact: Tf-6tJT' GT6 t2,J
CONTRACTOR Address: SZ3 Rgr#%A r AJE City. CAQ VC-rL r
State: rK t J Zip: _ SS !v 1 S' Phone: 6 I2 - PN03 S 13 1
License ZC G S 9 8 1 S Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
tt A JG
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classed as non-public if you provide specific reasons that would permit the City to
conclude that th_ev are trade secrets.__
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.gopherstateonecall oro
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.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
Applicant's Printed Name
Applica is Signature
Page 1 of 3
DO NOT W
y RITE BELOW THIS LINE
SUB TYPES
_ Foundation _ Fireplace _ Porch (3-Season) _ Storm Damage
Single Family _ Garage - Porch (4-Season) _ Exterior Alteration (Single Family)
_ Multi - Deck _ Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi)
- 01 of _ Plex _ Lower Level _ Pool _ Miscellaneous
- Accessory Building
WORK TYPES
- New _ Interior Improvement _ Siding _ Demolish Building*
_ Addition _ Move Building _ Reroof _ Demolish Interior
Alteration _ Fire Repair _ Windows _ Demolish Foundation
_ Replace _ Repair _ Egress Window X Water Damage
_ Retaining Wall "Demolition of entire building - give PCA handout to applicant
DESCRIPTION
Valuation Occupancy MCES System
Plan Review Code Edition f~ F SAC Units
(25%-100% Zoning City Water
Census Code Stories Booster Pump
# of Units Square Feet PRV
# of Buildings Length Fire Sprinklers
Type of Construction Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final / C.O. Required
Footings (Addition) Final / No C.O. Required
Foundation HVAC Gas Service Test Gas '
- Lme Air Test
Drain The Other:
Roof: -Ice & Water -Final Pool: -Footings -Air/Gas Tests -Final
Framing Siding: Stucco
Lath Stone Lath Brick
Fireplace:
In Air Test _Rough -Final Windows
Insulation Retaining Wall: - Footings - Backfill Final
Sheathing Radon Control
Sheetrock Erosion Control
Reviewed By: , Building Inspector
RESIDENTIAL FEES
Base Fee
IV
Surcharge
Plan Review`
P
MCES SAC
City SAC y
Utility Connection Charge /
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
PERMIT
City of Eagan Permit Type: Plumbing
Eaaan. Permit Number: EA102970
Date Issued: 02/09/2012
OR Permit Category: ePermit
41~ it~ of E3
E
Site Address: 1866 Jade Lane
Lot: 3 Block: 5 Addition: Cedar Grove 7th
PID: 10-16706-05-030
Use:
Description:
Sub Type: e - Fixtures
Work Type: New
Description: Main Floor
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments: Neil Couture
62 Hamlin Ave So
Saint Paul. MN 55105
651-699-2725
Fee Summary: PL - Permit Fee (miscellaneous) $55.00 0801.4087
Surcharge-Fixed $5.00 9001.2195
Total: $60.00
Contractor: - Applicant - Owner:
North Star Plumbing & Heating Jule D Gross
62 S Hmnline 1866 Jade Lane
St Paul NIN 55105 Eagan MN 55122--210
(61)699-272
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 Cite of Eaaan Ordinances.
ApplicantiPermitee: Signature Issued Bv: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA139842
Date Issued:11/10/2016
Permit Category:ePermit
Site Address: 1866 Jade Lane
Lot:3 Block: 5 Addition: Cedar Grove 7th
PID:10-16706-05-030
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
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.
Contractor:Owner:- Applicant -
Jule D Gross
1866 Jade Lane
Eagan MN 55122--210
Haley Comfort Systems
122 3rd St W
Hastings MN 55033
(651) 437-0338
Applicant/Permitee: Signature Issued By: Signature