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4710 Lund PtRESIDENT OWNER Name: 7/ Phone: Address City Zip: //6 //Pe 7 Applicant is: Owner K Contractor TYPE OF WORK Description of work: re (t Construction Cost: Z i9 Multi- Family Building: (Yes No CONTRACTOR Name: p ve-I.-) Con.C2. Q l_,l1 .5 License 20(o 5 (4.3(0 5 Address: Z8 ?-i V rtiv City: C IT kO State: t'Y■ 1\ Zip: S 3 Phone: C911-- ;St— �S j -1 Contact Person: (Ln m? COMPLETE In the last 12 months, has Yes No If yes, THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING the City of Eagan issued a permit for a similar plan based on a master plan? 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 conclude that they are trade secrets. City of Evan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 r For Office'use Use BLUE or BLACK Ink c Permit Permit Fee: 5.0. 06 Date Received: Staff: (2' 2009 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: rt /z/1/ Tenant: Suite 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.orq 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 st wit ut a permit; tiat the work will be in accordance with the approved pl n in the case of work which requires a review and approval of pl. s. x Applicant's Printed am• AppI 's S gna Page 1 of 3 CITY OF EAGAN WATER SERVICE PERMIT 3795 Pilot Knob Road PERMIT NO.: _ Eagan, MN 55122 DATE: Zoning: No. of Units: Owner: Address: Site Address: _ Plumber: Meter No.: —_ Connection Charge: Size: Account Deposit: Reader No.: Permit Fee: 1 agree to comply with the City of Eagan Surcharge: Ordinances. / Misc. Charges: _ Total: By /fr � Date Paid: D., - of I r„ Insp.: CITY OF EAGAN SEWER SERVICE PERMIT 3795 Pilot Knob Road PERMIT NO.: Eagan, MN 55122 DATE: Zoning: No. of Units: Owner: Address: - - -- — — _ - -- — -- - - - -- Site Address: Plumber: agree to comply with the City of Eagan Connection Charge: Ordinances. Account Deposit: Permit Fee: Surcharge: By Misc. Charges: _ Date of Insp.: Total: Insp.: Date Paid: Use BLUE or BLACK Ink r - - - - - - - - - - - - - - - - - I For Office Use r a~ ; Permit#: City of Ea q-1 o R I Permit Fee: I 3830 Pilot Knob Road Eagan MN 55122 Date Received: 1'~ Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: I _ 22013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Irn 13 Z 1 Site Address: T 7~1 7 y71'0 y71y O Pt Unit Name: AIJ060 1 pw- 4g Phone: Resident/ Owner Address / City / Zip: Applicant is: Owner X__ Contractor Type of Work Description of work: #J-,0 V Construction Cost: ,0O0 Multi-Family Building: (Yes / No ) Company: laic o~9 d _,jtA AK 4"!tr7ebhtact: Contractor Address: 3212E %S ;W/ff; V~ e: X1_ e4 P City:" State: Zip: J 337 Phone: (Ol~' y ~~a J License n ai 6 G G 7 Lead Certificate 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 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.-qopherstateonecall.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 State Building Code ust b completed within 180 days of permit issuance. x x Applicant's Printed Name Ap ant's nature Page 1 of 3 PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA126312 Date Issued:08/20/2014 Permit Category:ePermit Site Address: 4710 Lund Pt Lot:1 Block: 04 Addition: Ridgecliffe 2nd PID:10-63981-04-010 Use: Description: Sub Type:Residential Work Type:Replace Description:Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Janel Behrends 122 West 3rd S Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088 Surcharge-Fixed $5.00 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 - Kim R Stigsell 4710 Lund Pt Eagan MN 55122 Haley Comfort Systems 122 West 3rd St Hastings MN 55033 (651) 437-0338 Applicant/Permitee: Signature Issued By: Signature