4143 Ruby LaneCity of EaaH
J
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
CONTRACTOR
TYPE OF WORK
Address City Zip:
RESIDENTIAL
Furnace
Air Conditioner
Air Exchanger
Heat Pump
Other
_Ow 4.144•1_
Date:
Tenant:
City:
Phone: Sj Lf
New Replacemen
Description of work:
Contact Person:
Phone:
COMMERCIAL FEES:
$70.50 Underground tank installation /removal
$50.50 Minimum (includes State Surcharge) OR
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 (i.e. a $2,000 Permit Fee requires a $1.00 surcharge).
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and
I understand this is not a p t but onl a application for a permit, and work is not to start without a per t; that the work will be
plan i. he case of,work which J quires r `iew and approval of plans.
Contract Value
Suite
Ad ional Alteration f Demolition
COMMERCIAL
New Construction Interior Improvement
Install Piping r 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
Fee
State Surcharge
TOTAL FEE
es of the City of Eagan;. that
accordance ith the approved
Ret1u ti :this pectjo
Under Or
ga s Serrvjce'r
spedton
2009 MECHANICA
O
t A Site Ad./ss:
e 4
:l_r
RESIDENT /AL FEES:
$50.50 Mi Add -on or alteration to an existing unit (include
$90.50 Fire repair (replace burned out appliances, ductwork, etc.) (include
RMIT
s $.50 State Surcharge)
s $.50 State Surcharge)
PPLICATION
For Offi0O- Use
Permit
Permit Fee:
Date Received: /c9-- `/O
Staff:
6 z
TOTAL FEE
J
Use BLUE or BLACK Ink
JAI
I For Office Use
Permit#: k-1S of I Permit Fee: 1E2~
City Ea~d
3830 Pilot Knob Road I
Eagan MN 55122 t
Phone: (651) 675-5675 i Date Received: 1 3
Fax: (651) 675-5694 j Staff: I
L-----------------I
2013 COMMERCIAL BUILDING ERMIT APPLICATION S u.~ I
Date: 1 27 1-75 Site Address: YGIV
Tenant Name: 0-,,VR j convoy", a.~►\\S ®4,.~ ~ar~cn kor&'*(Tenant is: -New/ Existing) Suite
Former Tenant: Q
Name: ~tN Z.oeUne. S V~~~a.5 w~~ d1aC~,n IwncS Phone: lJo- 4 3 a• 87
9
Property Owner Address / City / Zip: P~~ok J N>3e_ o n~ n m 5,5-0 (0
Applicant is: Owner Contractor
Description of work ~GwC O~F on-\C- Govt GK~► 5"A1^h Ct~ai~
Type of Work Construction Cost- 155 1 3 11
Name: O ~ (_0V%5. ('QC1i o License V5 L Z2 t a
Contractor Address: kouvtd{ lc_ ayL City: 1~5L ~yJ~'1 T
State: M 1 Zip: J~t~( Q Phone:G S- I" 2 k;L
f
Contact: LC4. Email:
Name: Registration
Architect/Engineer Address: City:
State: Zip: Phone:
Contact Person: Email:
Licensed plumber installing new sewer/water service: 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.
- . n..,........ r..... m_t
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.aopherstateonecall.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.
x
x D -qm. wi
Applicant's Printed N We Applicant's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA170286
Date Issued:06/25/2021
Permit Category:ePermit
Site Address: 4143 Ruby Lane
Lot:072 Block: 04 Addition: Diffley Commons 2nd
PID:10-20451-04-072
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 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 -
Kelly J Resch
4143 Ruby Ln
Eagan MN 55122--216
Renewal Andersen
1920 County Road C West
Roseville MN 55113
(641) 264-4088
Applicant/Permitee: Signature Issued By: Signature