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3684 Robin Lane Use BLUE or BLACK Ink r C o f Eapft For Office Lase itV T Il Permit i I L J Permit Fee: IL! a.' 3830 Pilot Knob Road t Eagan MN 55122 Date Received: Phone: (651) 675 -5675 r r) Fax: (651) 675 -5694 Staff: 2009 RESIDENTIAL BUILDING PERMIT APPLICATION r, i Date: I Site Address: j ,lC._ ,F /7 i �"J Zy) Tenant: 4 1" 1�'v Suite RESIDENT OWNER Name: 5 Phone: 6/). 7Cl'Y7 7 Address City Zip: ,,r te v- :Y Applicant is: Owner Contractor TYPE OF WORK Description of work: kc? c? 4`, 7 Construction Cost: L�/ (;7 0 Multi- Family Building: (Yes No V CONTRACTOR Name: License Address: City: State: Zip: Phone: Contact Person: 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 nonpublic' if you provide specific reasons that would permit the City to conclude that they are trade secrets. 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. Applicant's Printjd Name Applicant's 'gnature Page 1 of 3 PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA171763 Date Issued:08/30/2021 Permit Category:ePermit Site Address: 3684 Robin Lane Lot:021 Block: 01 Addition: Blackhawk Acres 5th PID:10-14304-01-021 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 - Murray & Patricia Weiss 3682 Robin Ln Eagan MN 55121 Pronto Heating & Air Conditioning 7415 Cahill Rd Edina MN 55439 (952) 835-7777 Applicant/Permitee: Signature Issued By: Signature