4271 Nybro Lane N- CITY OF EAGAN
? 3795 Pilot Knob Road Eagan, MN 55122 N2 4408
PHONE: 4548100
BUILDING PERMIT ReceiPt # '
To be used fer ° Dote . 19
Site Address - - Erect E] Occupancy -
Lot Block Sac/5ub. _ Alter ? Zoning - -
Porcel .# Repair ? Fire Zone
Enlarge p Type of ConsY.
w Nome Move ? # Stories
0 Address Demolish ? Front ft.
Z
City Phone Grode ? Depth ft.
m I Approrals Fees
Nome _
Address
A
Address
a'Z" City Phone
1 hereby acknowledge thot I have read this application and state that
the informotion is correct ond agree to comply with nll applicoble
5tote of Minn=soto 5tot,--Yes and City of Eagan drdinonces.
Signature of Permittee
A Building Permit is issued to: .21f_
`-
all work shall be dons in occordance with oll opplicable State of M i r
Building Officiol
Assessment _
Water & Sew.
Police
Fire
Eng.
Plonner
Council
Bldg. Off. _
APC
Permit
Surcharge
Pfan check
SAC = -
Woter Conn. • '??3. U?S
Water Meter
Totol 930.50
on the express condition that
Statutes and Ciry of Eagan Ordinances.
Perndt # Da[e luuad Pa?tnttlM
Plumbin9 ,r9 7 8-/9 - 7 7
Mechonicol 9'?0 _.?a -77 or
INSPECTIONS DATE INSP. Rough-In Flnd
Footings Date Insp. Dcte Inw.
Foundation Plumbing
Frame/ins. ! Methanicol
Final ? 9 a>-22
Remarks:
.,
,
rI T , r;nqP T ?'C;
Dote: - ?
CITY OF EAGAN
3795 Pilor Knob Road
Eogan, Minnesota 55122
Phone: 454-8100
PERMIT
Site Address: "i iscle
Lot Biock SublSec.
Name - - _ ?-?'
.
; Address _
O
ity St. Paul Phone:
` Na„e ?,()ui s S. Peter Co.
? Address 1::r54 Grand Ave.
c
S c;ty . Paul 551r)5
Phone:
This Permit is issued on the express condition that all work shall be
Minnesota Statutes and City of Eogan Ordinonces.
No. `' 97
Receipt No.: D721-
-
Single I
Residential "
Multi Res., Comm./ind. I
New/Alter./Repuir
Cost of Insiallation
Permit Fee 20.00
Surcharge • 50
?Total ?0' r'r)
done in cccordonce with all applicoble State of
Building Official
CITY OF EAGAN
.
3795 Pilot Knob Rood
? Eagan, Minnesota 55122
Phone: 454-8100
?TIi;I: PERMIT
No.
940
Date: uly 20, 1977
Site Address:
Lot Block Sub/Sec. _- ? bth
Name ' - = - -1
1
; Address
O
City S r_ . Paul Phone:
` Na 1? i:-.aer & Son --
?
Address
c
ts
City Phone:
This Permit is issued on the express condition that all work shall be
Minnesoto Stotutes ond City of Eagan Ordinances.
;
Receipt No.: 0675
Single
Residential
Multi Res., Comm./Ind. I
New/Alter./Repalr new
Cost of Instollation
Permit Fee ? ? • ?''?
Surcharge • ? ?
Total ?_"), 50
?I
?
done in accordance with all applicable State of
Building Official
dft CASH RECEIPT
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE
19
RHC EI V ED
FROM
AMOUNT $ I
& OOLLARS
?aa
E] CASH [-] CHECK
KOR
06740
NUMERICAL FILE COPY
?? B Y
Rooeipt MECHANICAL PERMIT Pert nit No.
CITY OF EAGAN ,
FM
fll/ in numbened apscet S/C
Type or Ptin[ legibJY Tot.
1. Date - 2. Installation Cost
3. Job Address Lot Bik. Tract
4. Owner
5. Contrsctor Phone %`- - -? - ?~
V•
6. Address ? E C5
7. Gty State 2iP
8. Building Type: Residential 'rC7 Commercial O Institutional 0
9. Work Description: New Add O Alter ? Repeir ?
10. Describe
11.
i
!?
Type
No• Eqyjnment 8TU - M. Ea.
Forced Air No, Eauiament CFM
Air Handling:
?
Mfg.
Boilers M
E
Mfg. ech.
xhaust
Unit Heater ,
Mfg. Other
Air Cond.
Mfg.
Gas, P'iping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Y
Signed : for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Appr oved CITY OF EAGAN 454-8100
.:? . .
CITY OF EAGAN Remartcs
Addition Lot 4 81k 3 Parcel 10 84355 040 03
Owner L Q r'j I Street 4271 North Nybro Lane State Eagan, Minnesota 55123
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK
OND/
197
161.21
8.04
20
121.01
C003495
-30-77
SEWER LATERAL
WATERMAIN
WATER LATERAL
WATER AREA 1977 162.14 -?'? ?9b 15 151.34 C003495 -30-77
STORM SEW TRK 3 2,21- 1 441.53 C003482 9-I2-77
STORM SEW lAT
CURB & GUTTER
SIDEWAI.K
STREET LIGHT
WATER CONN.
(.,
- 7
BUILDING PER.
SAC - V - 7 7
PARK _a
CITY OF EAGAN SEWER SERVICE PERMIT
3745 Pilot Knob Road PERMIT NO.: - ..
Eogan, Mhl 55122 DATE:
Zoning: No. of Units:
Owner: -
Address:
Site Address:
Plumber: _-- ?
1 agree to comply with ti+e City of Eagon Connection Chorge: ,.
Ordinances. Account Deposit:
Perrnit Fee:
Surchorge:
B} - - Misc. Charges: F
Qote of Insp.: Total:
lns¢. Dote Paid: ?
:-. ;
OF EAw+N WATER SERVICE PERMIT
Pilot Knob Road PERMIT NO.:
, MN 55122 DATE:
No. of Unirs:
Address:
No.:
eader No.:
agree to comply with the City of Eogan
of Insp.:
Connection Charge:
Account Deposit:
Permit Fee:
Surcharge:
Misc. Chorges:
Total:
Date Paid:
I nsp..-.
cirr oF eaGnN
3795 PiIM Knob Rood Eagan, MN 55722
PHONE: 4548700
BUILDING PERMIT APPLICATION $50,000. Receipt #
To ba used fo. Sing. Fam Dwlg. d Garg, pate
N2 4408
6740
July 19, 1 g 77
Site Address 4271 NO. Nybro - Erect ?j Occupancy I
Lot 4 Block 3 Sec/Sub. WR 6 Alter ? Zoning RL
Parcel # Repoir ? Fire Zone _
Enlorge ? Type of Canst. V
rc Name Robert W Hill Move ? # Stories
= Address
? Demalish ? Front 66 ft.
Ci Phone Grade ? DeDth 44 ft.
p Name Ti1seA Homes, InC. AvProvols . Peea
j
Address 627 Rn_ Cno] j1T1
u
AVB P.ssessment Permit 140_50
'
g
?
.
Cic St. Paul pho„e. 454-4784
Water & Sew.
Surtharge 25.00
Police Plan check
ww Name
w Fire SAC 475.00
?
x? Addreu- Eng.
0
Water Conn. 230.0
<w Ci Phone Planner Woter Meter 60.00
Council
I hereby acknowledge thof I have read this application and state thot gldg. Off.
the intormation is correct and agree ta comply with oll applicoble APC Totul 930.50
State of Minnewta Stotutes and City of Eagon Ordinences.
Signature of Permittee
A Building Permit is issued ro: Tilsen Homes, IIIC, on the express condition that
all work shall be done in accorda/ce with all appt ble Stote of Minnesota Statutes and City of Eogan Ordinances.
Building Officiul . -? ? -
i
44•5U I}UULL
This request void 18 months from
,,?t o 49`s-o
P 10362
Date of this Request 7-22-77
I, as EkLicensed Electrical Contractor ? Owner, do hereby request inspection of the above electri-
cal wiring installed at:
Street A re?5s or ? o. 4271 Id bro -.-city Ea.gan
I`
Section Township Range County Dakota
Which is occupied by Tilsen $omes
Is a roughin inspection required on this job? No ? Yes R Ready Now ? Will Call {r3c
PowerSupplier Dakota CtY• Address Farmir_gton
Electrical Contractor 0 R Thompson F1PCtric Co Contractor's License No.3250i
(GOmpany Name)
MailingAddress 12201 i:Ttka .Rlvr3. Vtka> >55U3
Authorized Signature " `" Phone
(Electrical Contractor or Ownef Makin9 Thls Installatlon)
Minnesota State Board of Electricity
1954 University Ave., St. Paul, Minn. 55104-Phone 645-7703
' REQUEST FOR ELECTRICAL INSPECTION
CHECK BELOW WORK COVERED BY THIS REQUEST
p 10362
Type oY Building New Add. Rep. Check Appllances Whed Fot Check Equipment Wued For
Home 3f3?' ? ? Range 0(4-00 Temporary W'ving ?
Duplex ? ? ? Water Hea[et W.00 Lighdng Fixtu[es ?
Apt. Bldg. ? ? ? Dryer C92 • 00 Electric Heating ?
Commercial BWg. ? ? ? Furnace Fck2.00 S0o UNoader ?
Industrial Bldg. ? ? ? Ai[ Conditione[ ? Bulk Mtlk Tank ?
Fazm ? ? ? List Lis[
Othe= 0 0 0 Rthers? .
ere ) ,, Others?
Here 1
COMPUTE INSPECTION FEE BELAW
Service Entrance Size: # Fce Feedeis&Subfcedets: #. Fee Ci[cuita: # Pee
0 to 100 Am s. 0 to 30 Am res:1 ? \ 0 to 30 Am res f3 16.oo
301 ro 200 Am s. 31 to 100 tiri . re3-!, , \ 31 to 100 Am eres
Above 200 mpa 14-00 Apd"e: DO , +?1nps. ,'? : - Above lOQ_Amps.
Transformers RemotcCodtEOY"l°art. Partialorothe:fee
Signs S` Ins tion Minimum fee $5.00
Remazks
Hall
-f
TOTALFEE
44•50
I, the Electrical Inspector, hereby ft y t oy? ction has be d?j ?/v-ov
(Rough-in) r•r?-i Date
(Final) Date ? 12
This request void 18 months from
CITY USE ONLY
Tl
LOT _If_ BL %3 PERMIT #: 47OOk?
b /?h
SUBD. RECEIPT #: . L/ K' 3 O '573
RECEIPT DATE: 71M
2000 MECHANICAI, PERMIT (RESIDENTIAL)
Date: / :o2S" QQ
Complete this section onlv if you are installing HVAC in a single family dwelling, townhome or condo under
construction and not ownedoccupied.
• HVAC: 0-100 M B T U
ADDITIONAL 50 M BTU
• Gas outlets (minimum of one required @$3.00 ea.)
$ 30.00
6.00
State Surcharge .50
Total $
Complete this section onlv if you are remodeline, addin?to, or reoairine an existing single-family dwelling,
townhome, or condo. Please indicate if it is a new item, alteration, or repair.
_ New X Alteration
? Furnace
_ Air exchanger
_ Repair
?
_ Other
A'v conditioning
Other
Fee
Siate Surcharge
Total
Reminder: Call for inspections
SITE ADDRESS:
$ 30.00
.50
30.50
OWNER NAME: TI v1 ?.IO?YI Jf/? PHONE (M51-
CODE)
INSTALLERNAME:?P Y? LJV???S??J PHONE#: io/a - 11M_ D
STREET ADDRESS: y? "15n V ?L a, ^ U uI k =P E)
CITY:
CITY OF EAGAN
3830 PILOT IQ108 RD
EAGAN M 55122
651-681-4675
STATE: A) ZIP: .?l-?/
Ail .eJ? )e ? 0 irLGl?
SIGNATURE OF PERM TfEE
CITY USE ONLY
L BL
SUBD.
APPROVED BY: , INSPECTOR
PERMIT #:
RECEIPT#:
RECEIPT DATE:
2000 MECHANICAI, P&RMIT (C0M4lLRCIAL)
CITY OF EPaGAN
3830 PILOT IQNOB RD
EAGAN, MN 55122
651-681-4675
Please complete for: all commerciaUindustrial buildings
multi-family buildings when separate permits are not required for each dweiling unit
DATE
WORK T'YPE: New construction _ Install U.G. Tank
_ Interior Improvement _ Remove U.G. Tank
_ Processed Piping
When Installing/removing uxderground tank, call 651-681-4675 jor inspection by fire marshal and
plumbing inspector.
Description of work:
Fees: i% of contract price OR $30.00 minimum fee, whichever is greater.
Underground tank removaUinstallation = minimum fee
Contract price: $ x 1%= $ (Base Fee)
State surcharge calwlate at $.50 for each $1,000 Base Fee
TOTAL S
SITE ADDRESS:
OWNERNAME: PHONE#: -
(AREA CODE)
TENANT NAME (IMPROVEMENTS ONL1):
WAS THERE A PREVIOUS TENANT IN THIS SPACE? _ Y_ N. NAME:
INSTALLER:
ADDRESS:
CITY:
PHONE #:
(AREA CODE)
STATE: ZIP:
SIGNATURE OF PERMITTEE
Date :
_,.?.
BUILDrLtG PEFMI"x' PPPLICr:TIO?T
LOTBLOCK 3 1fJDITIO:S
PARCEL & SECTIOII 11U-11IIER IF UiIPT.ATTED
riouxFSS oF
WAr,Tc
ssTL?ta= cosT
O['!]E:t '<'? y /'?'j TyLEPHOI4E i40.
?? ? -?11
CONTtIACTOR TELEPHONL :?O. yiSv/ = 7? SY .
AUDiZESS
Note- Include site plan; buildiag plans, and eneray calculations with this
application
Sianed
OFFICE USE
VALUAT=o0 6-6n n v
sAc
00
S•dAT3R ME'SE2
BUZLDING PF.P.L12T FEE
SiTRCHAI2GE FLR
PLi11; Cfx-Clt E`i--^
00
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PARK DEUIC.ATIOiJ FEE
OT; r R
TOTP>L*
APPROVALSe
ASSESSAIE:^P CLERK ? BUILDING D POLICE DEPT
•+]ATER & S:sF7ER DEPT. FIRE-.DL'PT. PA,RK DEPT
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?WICRILINC:
!'OTAL k4PA : y9. f!.
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5•
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?.If averaga
'b" valuae •s ea1culaCed abory
do not
rst the Bqotgr Cod• ,
roquireracs.
tM "Alteroaca Envelope Dasign" as wtila" in SeC 6004 (s) maT Sa used. Addicioaal
sheets am7 be used to shw oaleulations.
' ' . t.
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2835 Z(/. 14AWb e/fW" 86
.94 p"4 M&m"a& 55sfa
p/wne: 636-4600
November 15, 1978
Mr. Robert Hill
4271 N. *bro Lane
Eagan, Mn. 55123
Re: Storm Water Flooding
Eagan, Minnesota
Fi1e Nn. 49 Storm Sewer System
Dear Sir:
1
otro C. 8onu(roa, P.E.
Raberl W. Roatne, P.E.
louPh C. dnderdk. P.E.
BradJord A. Lemberd• P.E.
Ro6a! D. PdgaarE, P.E.
Ricfiard P. Tumn, P.E.
Janu C. Olmn, P.E.
Lawnnca F. Feldrlan, P.E.
G(enn R. Cook, P.S.
Kelth A. Gordon, P.P..
7Mma, E. Noysi. P.£.
Rlchard W. Failer, P.F.
Roben O. ScAUxlahi, P.E.
Ma,vin L. Sorvala. P.S.
Donald C. 8urgardh P.F.
Xennerk R. Msbler, P.S.
Char7ea A. Srlckaon
Lso M. Powelrky
Narfan M. Ohan
You have requested information on the storm water flooding of your basement walk-
out home during the storm of August 26, 1978 and the potential of this ever
happening again.
After reviewing the storm sewer system, the size of the storm and the unique con-
ditions existing in the area at the time of this flooding, it is our opinion
that it is very unlikely that flooding of your walkout basement will ever occur
again. The following are the reasons for this conclusion:
A. The elevation of Carlson Lake was at an a11 time high when the storm
occurred, making it difficult for the excess flow to move from the ponding area
behind your house into Carlson Lake. Since that time, the installation of a
storm water pumping station on Carlson Lake has been authorized and is under con-
tract for construction in Spring, 1979. This station will keep Carlson Lake at
its approved normal elevation approximately 8' lower than it was in August. It
will be able to receive storm water from adjacent ponds without flooding.
B. The storm of August 26, 1978 was very unusual. Information received
from the State Climatologist indicates that it was in excess of a 200 year storm.
This means that, on a statistical average, one would expect such a storm to
occux on the average of once in a 200 year period.
C. The development north of Co. Rd. 30 was under construction at the time.
A major ponding area planned to receive much of the storm water runoff from the
southern portion of this development was not yet graded to hold back the water
during this storm. The consequence was an unusual amount of runoff from this
area which flowed across Co. Rd, 30 into your ponding area in a very short time.
This pond has since been properly shaped. If such a storm were to occur now,
the excess flow would be ponded and allowed to flow out slowly through an over-
flow control structure.
Z"I
Page 1.
Mr. Robert Hill November 15, 1978
Eagan, Mn. 55123
Re: Fi1e No. 49 Storm Sewer System
It is probable that if the conditions of either A. or C. were not present at the
time of the storm, no flooding of your home would have occurred as the system
has a sufficient safety factor to handle the storm which we had. With these
facts in mind, we do not believe you wi11 have the flooding condition again.
Yours very, truly,
BONESTR00, ROSENE, ANDERLIK & ASSOCIATES, INC.
Robert W. Rosene
RWR:1i
cc: Tom Hedges
Tom Colbert
Alyce Bolke
Paul Hauge
Page 2.
s6c- ';?7
SEVERSON,SHELDON,
DOUGHERTY & MOLENDA, P.A.
SUITE 600
7300 WEST 147TH STREET
APPLE V.4LLEY, MINNESOTA 55124-7580
(952) 432•3136
TELEFAX NUMBER (952) 432-3780
E-MA1L bauerrrGilsevessonsheidon.com
TO: 70 order, Assistant City Engineer
FROM: Robert B. Bauer, City Attomey ?
DATE: November 10, 2003
RE; Vazious Easements
6"C'c
l??"7/ ? ?CO 1?nf
?
P8=5"
John,
Enclosed please find the original recorded easements regazding Projeci 819 as follows:
A. Drainage and Utility Easement dated July 11, 2001 and recorded July 30,
2003 with the Dakota County Recorder as Document No. 2086163 (Daniel
and Janet Adrian - Easement No. 954/Project 819);
B. Drainage and Utility Easement dated August 27, 2001 and recorded July
30, 2003 with the Dakota County Recorder as Document No. 2086164
(Daniel and Marie Grinols - Easement No. 964/Project 823):
C. Drainage and Utility Easement dated July 16, 2001 and recorded July 30,
2003 with the Dakota County Recorder as Document No. 2086165 (Ann
L. Johnson - Easement No. 955/Project 835);
D. Drainage and Utility Easement dated July 9, 2001 and recorded July 30,
2003 with the Dakota County Recorder as Document No. 2086166 (Larry
and Marcia Miller - Easement No. 958/Project 819);
E. Drainage and Utility Easement dated July 11, 2001 and recorded .luly 30,
2003 with the Dakota County Recorder as Document No. 2086167 (Phillip
F. and Mary E. Popehn - Easement No. 959/Project 833); .
.?
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DAKOTA COUNTY
TFiEABURE?R
DRAINAGE AND UTILITY EASEMENT
THIS EASEMF'NT? made this L (P day of ,- LV4 , 2001, between. ANN L.
JOHNSON /(Rereih9#er regerWo as "Landowner"), and the ITY OF EAGAN, a municipal
corporation, organized under the laws of the State of Minnesota, (hereinafter referred to as the
loCiTy„)
WITNESSETH:
That the Landowner, in consideration of the sum of One Dollar ($1.00) and other good
and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, does
hereby grant and convey unto the City, its successors and assigns, a percnanent drainage and
utility easement, over, across and under the following described premises, situated within Dakota
County, Minnesota, to-wit:
A permaiient drainage and utility easement over west 10' and south 10' of
Lot 4, Block 3, Wilderness Run, 6'h Addition.
The grant of the foregoing permanent easement for drainage and utility purposes includes
the right of the City, its contractors, agents and servants to enter upon the premises at all
reasonable times to construct, reconstruct, inspect, repair and maintain pipes, conduits and mains;
and the further right to remove trees, brush, undergrowth and other obstructions. After
completion of such construction, maintenance, repair or removal, the City shall restore the
premises to the condition in which it was found prior to the commencement of such actions, save
only for the necessary removal of trees, brush, undergrowth and other obstructions.
And the Landowner, its successors and assigns, does covenant with the City, its
successors and assigns, that it is the Landowner of the premises aforesaid and has good right to
grant and convey the easement herein to the City.
RECEIVED
?;1, 1, `;Oi
DAKG iA W.:NTY
TREA9UFiER-AUDITOH
IN T'ESTIMONY WFIEREOF, the Landowner has caused this easement to be executed
as of the day and year first above written.
ANN L. JOHNSON
STATE OF MINNESOTA)
COUNTY O w?-C )ss.
The foregoing instrument was acknowledged before me this day of
J-J 12001, byANNL. JOHNSON, a single person.
Not Public
APPROVED AS TO FORM: ?
-? JAMESE.FFtUECHTL
1
NoWiIN&IC-Mwr?ESOiA
? ? ? MY COMMISSION IXPIRE
$ ?
JANUARY 31, ZOpfi
City Attomey's Office
Dated: 5/iilo t
APPROVED AS TO CONTENT:
C --/
Pub ' Works De artment
Dated: / 2,-'-d
THIS INSTRUMENT WAS DRAFTED BY:
SEVERSON, SHELDON, DOUGHERTY &
MOLENDA, P.A.
7300 West 147th Street, Suite 600
Appfe Valley MN 55124
(952) 432-3136
Easement #955
Project #835
Use BLUE or BLACK Ink
r - - - - - - - - - - - - - - - - -
I For Office Use
ermit#: I ~ ~o SI I I
City I I
n
of P
Ol Ea~,,
I Permit Fee:
I
3830 Pilot Knob Road
Eagan MN 55122 Date Received: -3 3
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff: I
I I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit
i
' Name:
n~ Phone:
Resident/
Owner Address / City / Zip: 1L)l,4vn Li
i
Applicant is: Owner ontractor
Type of Work Description of work: ke v^oe> 4
i
~ Construction Cost: Multi-Family Building: (Yes / No )
3 _
i Company: ~j44 vt~ L+~ Contact:
i Contractor Address: !~,lecr,-&4 d:/ p f7 t~ City: ~-t Q
' State: 1 t cJL Zip: ~j Vr Phone:
i CPS'l ~d`?t la fS S-
License ' 9q Lead Certificate
I
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
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 classified as non-public if you provide specific reasons that would permit the City to 1
conclude that they 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.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 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 to Building Code must be completed within 180
days of permit issuance.
X~~ J x
Applicant's Printed Name Applicant's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA167314
Date Issued:03/09/2021
Permit Category:ePermit
Site Address: 4271 Nybro Lane N
Lot:004 Block: 003 Addition: Wilderness Run 6th
PID:10-84355-03-040
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507)
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 -
Ann L Johnson
4271 Nybro Ln N
Saint Paul MN 55123--174
Standard Heating & Air Conditioning
130 Plymouth Ave. N
Minneapolis MN 55411
(612) 824-2656
Applicant/Permitee: Signature Issued By: Signature