1811 Walnut Lane - ME 915254 11/1. City of Eaau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
2009 MECHANICAL PERMIT APPLICATION
Date: t (__0 1 Site Address: 4..
Tenant: t t 1
RESIDENT OWNER
CONTRACTOR
TYPE OF WORK
PERMIT TYPE
Name: P n Phone:
Address City Zip: a t t CAS t r --i11. f Cal (rict n JS La
License #A LL 05'1 q 8
Dan Wohlers Southside Htg. A/C
6950 W. 146 St., #106
Apple Valley, MN 55124
(952) 431 -7099
State:
t Person: c.) if
New 1 Replacement
p 1 L LL
Descri tion at work: �C:irC'�,�.; 1 -.L.t C' r 11 t.
RESIDENTIAL
w
Air Conditioner
Air Exchanger
Heat Pump
Other
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)
5 SO TOTAL FEE
COMMERCIAL FEES:
$70.50 Underground tank installation /removal OR
$50.50 Minimum (includes State Surcharge)
if Permit Fee is Tess than $1,000, surcharge is $.50.
If Permit Fee is $1,000, surcharge increases by $.50 for each
$1,000 Permit Fee (Le. a $1,001 $2,000 Permit Fee requires a $1.00 surcharge).
x Chad CahWex
Applicant's Printed Name
Additional
Contract Value
Applicant's Signature
Permit I
Permit Fee:
Date Received:
Staff:
Alteration
Suite
Zip:
Demolition
COMMERCIAL
New Construction Interior Improvement
Install Piping Processed
Gas Exterior HVAC Unit
Under Above ground Tank Install Remove)
When installing /removing tank(s), call for inspection by Fire
Marshal and Plumbing Inspector
x 1%
Permit Fee
State Surcharge
TOTAL FEE
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 plan's.
equired Inspections:... Under Ground Rough.. In Air Test
Extertor:HVAC Screen
FOR OFFICE