3930 Turquoise Pt CITY OF EAGAN Remarks Sew & wtr nermits and sehr conn, pd.. on 3-5-62
Addition Cedar Grove #6 Lot41 Blk ~ Parcel l[L1A?_[1K 1}1(L(1(
Owner&~~~y ~~-11'16i;~`-~'u lStreet 3930 TlirQllOise P1''. State ESgH1t1,MN 5K122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK
SEWER LATERAL 1
WATERMAIN
WATER LATERAL 1
WATER AREA
STORM SEW TRK 1970 20
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
sAC 200.00 1249 3-10-69
INSPECTION RECORD
e-,~ITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number. i1 tiAH
Eagan, Minnesota 55122-1897 Date Issued: `
(fi 12) 681-4675
, .
SITE ADDRESS: APPLICANT:
~ •~i~nt~t~ F R
PERMIT SUBTYPE: TYPE OF WORK:
INSPECTION . .
, . . .
F' ~
~
L
Pertnk No. Partnit Holder Dete Tetephone #
ELECTRIC
PLUMBING
HVAC
InspecNon Data Insp. CommeMs
F0071NGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
EAGAN TOWNSHIP
BUILDING PERMIT N°• 1956
Oweax y...d`----4.e.,........---- Eagan Township
Addreae (prasen!) ......u-.-...--.i~....,.._~f..7_<.:.'c`...'~~........................ Town tiall
Builder /
/o
Dale
.l.~.-~
Addrass .
DESCAIPTION
Siories To Be Used Fas Froni Depih Heigh! LEst. Cos! Permit Fee Remarks ~
LOCATIONSi ~'O~~
Slreel, Road or oiher Deseripfion of Loeafion I Lo! Block Addition or Traet
s-~~ 9 9
~ ol
T6is psrmit does not aufhorisa !he use of sireels, roads, alleys or sidewalks nor does it give the owner or his ageni
the righ22o creale anp aifualion which is a nuisance or which presenls a hazard !o the heal2h, safefy, eonvenienca and
general welfare !o anpone in the eommuniSy.
THIS PERMIT MUST BE KEPT OF TH£ PAEMISE WHIL£ THE WORK IS IN PAOGRESS.
_ !o ereaY a.._
This is !o aerlifY, ihal---.~..... -.'has permission . . . upon
the above deseribed premise subjeei !o the provisiona of the Building Ordinance for Eaqanahip ado ed April 11,
1955. ~ Q~ ~~9~
..`.r~'~`'^^......~y.'...._l.`.x:4~..^:~._.........- Per f -K`- `y~"`~J
t/ Cha~Yman of Tnwn Board Suilding Inspecfor
~ G. Q_
EAGAN 1UWNSHIP
3795 P31ot Knob Road
St. Paul, Mianeaota 55111
Telephone 454-5242
PERMIIT FOR WATER SERVICE CONNECTION
Date: Number• 30f+r-~~'~
Billing Name: Site Address; 223 Owtter Billing Address
Plumber• C%
Location of Coanection Meter Size Connection Chg.
Meter No, Permit Fee 7.50
Meter ReadinpMeter Dep.
Meter Sealed: Yes Add'i Chg.
NO Total Chg.
Inspected by
DaCe
Building is a; Remarks:
Residence ~
Multiple A'o. Unita
Commercial
Industrial Bp;
Other Chief Inspector
In consideratioe of Che isaue and delivery to me of Che above permit, I
herehy agree to do ttie proposed work in accordance with the rules and
regulations of Eagan Township, Dakota County Minnesota.
By:
, Please notify the above office whea ready for inspection arnl connectioa.
EAG6iId TOWNSHIP
3795 Piiot Knob P.oad
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT POR SEdER SERVICE CONNECTiON
DATE• NCiMBER 355
,p .
OWNER: G~L .W.P.ddress 2936 PLUMBER TYPE OE PIPE
DESCRIPTION OF BUIIAING
Industrial Commercial Residential Multiple Dwelliag No, of units
X
ivcation of Connections: Connection Charge 200.00
PermiC Fee 7.50
Street Repairs
Total
Inspected by:
DaYe
Remarks•
By
Chief InsgecCOr
in ronsideration of the issue arni delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Tocroship, Dakota CounC:2z: Minnesota By e
Please notify when ready for inspection and connection and before any porCion
of the work is covered.
'.,'~I II ~~I
, . MEMO
cety of eagan
TO: DIANE DOWNS, UTfL1TY BILLING CLERK
FROM: ED KIRSCHT, SR. ENGINEERING TECH
DATE: AUGUST 25, 1993
SUBJECT: STREETLIGHT ENERGY COSTS
CEDAR GROVE NO. 6(141 LOTS)
This memo is to inform your department to begin to irnoice the energy costs at the single
family rate effective August 1, 1993 to the property owners in Cedar Grove No. 6 Addition
as listed below:
Block 1, Lots 1 1
Block 2, Lots 1-8 8
Block 3, Lots 1-18 18
B{ock 4, Lots 1-11 11
Block 5, Lots 1-9 9
Block 6, Lots 1-53 53
(tots 54 through 61, Block 6, should not
be billed at this time)
Block 7, Lots 1-12 12
BloCk 8, Lots 1-18 18
BloCk 9, Lots 1-11 11
TOTAL 141
The Ciry is currently being billed by Dakota Electric for streetlighting in the above listed
subdivision.
C,cIc~7
Ed Kirscht Sr. Engineering Tech
ca Mike Foertsch, Asst. City Eng.
EK/je
CITY USE ONLY
L~ BL C RECEIPT F~o~71 ~
5UBD. l j~4.~C~t_ ~JIY,OC~ #Lp RECEIPTDATE: y!n7
1997 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for. . single famity dwellings
& townhomes and condos when pertnits are required for each unit
New construction Add-on furnace
Add-on air conditioning Add-on air exchanger, i.e. Vanee system, etc.
Au CG YlA-{'I Dilj n ~ (WdM S UlA 1.Uuf
Date: L~ j Z3~ q 7
FEES
? Minimum Fes: Add-on/Remodel (existing residence only) $ 20.00
? HVAC: 0-100 M BTU <24:96---
Additional 50 M BTU -6:00-
? Gas Outlets (minimum of 1 required Q$3.00 each) liloya
? State Surcharge .50
so
TOTAL
SITE ADDRESS:
OWNER NAME: d- Mau Yl PHONE#:
INSTALLER NAME: 41G ~ ~ PHONE
STREET ADDRESS: LL L Znt)
CITY: LU CLn STATE: ZIP: 5-5122-
~ ,l_e'4 _/1 Cn4w)
SIGNATURE OF E ITTEE
CITY USE ONLY
L _ BL _ RECEIPT#:
SUBD. RECEIPT DATE:
1997 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNDB RD
EAGAN, MN 55122
(672) 687-4675
Please camplete for. . all commerciaVindustrial buiidings.
. muiti-famity buildings when separate pertnits are p21 required for each dweliing
unit.
DATE: CONTRACT PRICE:
WORK TYPE: _ NEW CONSTRUCTION INTERIOR IMPROVEMENT
DESCRIPTION OF WORK:
FEES: P $25.00 minimum fee Qr 1% of contract price, whichever is greater.
• Processed piping - $25.00
• State surcharge of $.50 per $1,000 of pe= fee due on all permits.
CONTRACT PRICE x 1 %
PROCESSED PIPING
STATE SURCHARGE
TOTAL
SITE ADDRESS: _
OWNER NAME: TELEPHONE
TENANT NAME: (IMPROVeMEnrcS oNLr)
INSTALLER:
ADDRESS:
CITY: STATE: ZIP:
PHONE
SIGNATURE:
SIGNATURE OF PERMITTEE CITY INSPECTOR
PERMIT
~ CI7Y OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55122-1897 Permit Number: 031808
(612) 681-4675 Date Issued: 0 4/ 17 / 9 8
SITE ADDRESS:
3930 TURQUOISE PT
LOT: 41 BLOCK: 6
CEDAR fiROVE 6TH
P.I.N.: 10-16705-410-06
DESCRIPTION:
(ROOFING)
pu:llding.„Permit Type SF (MISC.)
;`guilding Wp.rk Type REPAIR
Census Code434 YILT. RESIOENTIAL
'
r s
1C . - . ' .
. _ .
ti t
~
+
~al LJ5
REMARKS:
FEE SUMMARY:
VALUATION $3.000
Base Fee $79.75
Surcharge $1.50
Total Fee $76.25
~
1
CONTRACTOR: OWNER: - Applicant -
DUQUENNE RAYMOND
3930 TURQUOISE PT
EAGAN MN 55122
(612)887-5400
I hereby acknowFedge°that`I have re8d this epp,ticat3bn an(i stste tfiat ttve
infiormation is correct artd agree to comply with all applieable State of Mn.
~ Statutf~s and Gity of,Eagap Ordinanc`es.__
APPLICANT/PERMITEE SIGNATURE - ISSUEDlB :SI A URE k
~
998 BUILDING PERMIT APPLICATION (RESIDENTIAL) ~
CITY OF EA(}AN
516063830 PII.OT KNOB RD - 55122
681-4675
New Construction Reauirements RemodeVReoair Reauirements
? 3 registered site surveys ? 2 copies of plan
? 2 copies of plans (inGude beam & window sizes; poured fnd. design; etc.) ? 2 site surveys (exterlor add'Rions & decks)
? 1 energy calculations ? 1 energy calculations for heated addkions
? 3 copies of tree preservatian plan ff lot platted after 7/1/93 2-ZoQ
required: _ Yes _ No
0
DATE: - CONSTRUCTION COST;
DESCRIPTION OF WORK: ~~FLE p-~ d~~ ~ Pl~fE_~4ZC!';,T/f~-
STREETADDRESS:
OT: 41 BLOCK: SUBD./P.I.D.
i~tZ
~ Name: s~_J N•Q Ll v~ (~F Gk O A~~ Phone
PROPERTY 1~t First
OWNER Street Address: 3 -vu MZQ U o t SF_ P6 (11T'
City State: Zip:
Company: Phone
CONTRACTOR "
Street Address: License #
City State: Zip:
ARCHITECT/
ENGINEER Company: Phone
Name: Registration
Street Address:
City State: Zip:
Sewer 8 water licensed plumber (new construcGon only): . Penalty applies when address chang
and lot change is requested once permit is issued.
1 hereby acknowledge that I have read this application and state that the infortnation is correct and agree to comply with all applicabl
State of Minnesota Statutes and City of Eagan Ordinances.
Signature-of App nt:
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes _ No _ Not Required
OFFICE USE ONLY '
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
? 02 SF Dwelling ? 07 4-plex ? 12 Multi RepaidRem. ? 17 Swim Pool
? 03 SF Addition O 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility
? 04 SF Porch ? 09 12-plex O 14 Fireplace Vr 21 Miscellaneous
? 05 SF Misc. ? 10 = plex ? 15 Deck
WORK TYPE ~ 3 SC~
? 31 New ? 33 Alterations ? 36 Move
? 32 Addition ~ Repair ? 37 Demolition
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MC/WS System
(Allowable) Main level sq. ft. City Water
UBC Occupancy sq. ft. Fire Sprinklered
Zoning sq. ft. PRV
# of Stories sq. ft. Booster Pump
Length sq. ft. Census Code.
Depth Footprint sq. ft. SAC Code
Census Bldg
Census Unit
APPROVALS
Planning Building Engineering Variance
Permit Fee Valuation: $
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
% SAC
SAC Units
RESIDENTIAL BUII.DING
Permlt Appllcatlon
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephoue # 651-675-5675 FAX # 651-675-5674
NewCoreWCtlmRenuirmnen6 RemadeVReoairReweemenm OfsCaUseOnN
3 regismred sim wrveya shoxiing sq. R of bt sq. R of house; and aq mo(ed aMas 2 oopies al plan _ Cert of Survey Read
(20% maximum bt ooverage albwed) . t set of Energy Calailatbm fw hmted addidona _ Trea Pres Plan Reod
2 wpias of plan slnwvp beam 8 wiidow siaes: poured faurq design, eOC. 1 si0e wirey for additions 8 decka _Tree Pree Not Reqd
1 set al Erreigy Cakuletlms Adeitlon -'v,dicefe dmsiTe mpbc system _ On-sim SePtk SYsOem
3 mpies of Tree Preservetlon Plen 110 Dlatted afler 711193
Rim bbt Defail Op6ms selectlai sheet (hld8s with 3 or less unils
Date 4~ 1'51 0 3 Constr„ceooCost
Slte Address :~I L( O 15~ PT• Uoit/Ste #
Descripdan of Work i~ w
Muitl-Family Bldg _ Y~N Fireplsce(s) _ 0 _ 1_ Z
Property Owner ~ l il & 1il E N Telephone #
Great Lakes Window & Siding
Contractor 14650 Glenda DHve
Appls a ,
Address IMb~Y/~}pl 1QI0 ~au (95t) 89! a2se City
State Zip Telephone # ( )
COMPLETE TNIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Energy Code Category - Minnesota Rules 7670 Cate~ _ Minnesota Rules 7672
(J submission rypa) ' Residentlal Ventlladon Categay 1 WoAcsheet . New E~ . Waksheet
submitted 5ubmitted
. Enerpy Envelope CalpAatlans Submit0ad
Licensed Plumber Telephone
Mechanical Confractor Telephone ~ B
Sewer/Water Contractor Telephone )
I hereby apply for a Residenriat Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to stazt 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 ofplans.
) lA Ue ~vA l21J S ~ G-'v x
Applicant's Printed Name ApplicanYs gnature
OFFICE USE ONLY
Sub Types
? 07 FoundaUon O 07 0~'rplex O 73 16-plex O 20 Poal ? 30 Accessory Bldc
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) O 31 Ent. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Parch/Addn. (4sea.) ? 33 ExL Nt - SF
O 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
O 05 03-plex 0 11 10-plex 13 19 LowerLevel 0 24 Stortn Damage
? 06 04plex O 72 12-plex albp_Yw_N O 25 Miscellaneous
Work Types
O 31 New O 35 IM Improvemerrt O 38 Demolish (interior) ? 44 Siding
? 32 Addition O 36 Move Bldg. ? 42 Demolish (FoundaUon) O 45 Fire Repair
O 33 Alteration E3 37 Demolish (Bldg)' O 43 Reroof ? 46 Windows/Doors
O 34 ReplaCement roemolitlon (EnWe Bldg) • Give PCA handout to appllpM Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr, of Bldgs Length Fire Sprinklered _
Type of Const Width
, - . {''89J :ta? U4pr. c:fi ,S'e£; f',q
REQUIRED INSPECTI61~1b`0S'k •OU VA
_ Footings (new bldg) _ FinaUC.O.
_ Footings (deck) _ FinaVNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Framing _ Sid"mg Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (newheplacement)
_ Insulation _ Retaining Wall
Approved By , Building Inspector
6ase Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S8W Pertnit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
2004 RESIDENTIAL BUILDING PERNIIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction Reauirements RamodeVReoair Reouiremenfs 6No~
3 regis0e2d si0e surveys shaving sq. ft M bt, sq. ft ot house; and all mofed areas 2 copias af plan CeA d ~ N
(20% maximum lot averege allowed) 1 set of Energy Calculations tor heated addNons T(re;gy~'R eCd
2 copias of plan showing b~m 8 window sizes; poured found design, etc. 7 site survey for additbns & decks Tree [eS~,
t set of Energy Calculations AddPoon • irMlcete Aonsife sepfic system ptlc ~7kr
3 copies of Tree Preserva6on Plan if lol platted after 711/93
Rim Joist Defad Options selectlon sheet (bldgs wifh 3 or less unBs
i
Date / _ Construction Cost ~
SiteAddress -'ugail6o rt Pt UniUSte #
Description oP Work
,Yauiii-Faazily Sldg _ Yg N Fireplace(s) _ 0 _ 1 _ 2
PropertyOwner mGIRG OIAGlU-Pl1f'IP Telep6one#(yg I) q,5q- &/&I
Contractor Q t Cl
Address City I
State Zip EfD IZU Telephone # Z)
COMPLETE THIS AREA ONLY IF CONSTRUCTIN6 A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category . ResidenGal Ventilation Category 1 Worksheet • New Energy Code Worlcsheet
(4 submission type) . Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar planZ _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber Telephone ~
Mechanical Contractor Telephone ) 10 ~ c R 5 T m
Sewer/WaterContractor Telephone#( ~ SEP 14 2004
e~~
I hereby apply for a Residential Building Permit and acknowledge that the information i plete and accu te;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; 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 Printed Name Applicant's gnature
OFFICE USE ONLY
Sub Types
? 01 Foundation O 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 EM. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screenlgazeho) ? 36 Multi Misc.
? 05 03-plex O 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Pibg_Y or_ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building` ? 43 Reroof ? 46 Windows/DOOrs
? 34 Replacement *Demolitlon (Entire Bldg) - Give PCA handout to applicant
Valuation Occupancy i MCES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) Final/C.O.
_ Footings (deck) Final/No C.O.
_ Footings (addition) _ Plumbing
_ Foundation HVAC
_ Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests Final
_ Framing _ Siding _ Swcco _ Stone _ Brick
_ Fireplace _ R.I. _ Air Test _ Final _ Windows
_ Insulation _ Retaining Wall
Approved By: , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA114721
Date Issued:09/18/2013
Permit Category:ePermit
Site Address: 3930 Turquoise Pt
Lot:41 Block: 6 Addition: Cedar Grove 6th
PID:10-16705-06-410
Use:
Description:
Sub Type:Reroof & Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation.
Valuation: 8,000.00
Fee Summary:BL - Base Fee $8K $162.25 0801.4085
Surcharge - Based on Valuation $8K $4.00 9001.2195
$166.25 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 -
Raymond L Duquenne Tste
3930 Turquoise Pt
Eagan MN 55122
(651) 454-6187
Reroof America
10740 Lyndale Ave S
Suite 10W
Bloomington MN 55420
(952) 888-8440
Applicant/Permitee: Signature Issued By: Signature
41,11 City ofEapn
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
RECEIVED
SEP 062016
Use BLUE or BLACK Ink
For Office Use
Permit #: 13°69?
/0p
Permit Fee: l0 -
Date Received: 2 -" -/(3.
Staff:
2016 MECHANICAL PERMIT APPLICATION
❑ Please submit two (2) sets of plans with all commercial applications.
j.
Date: 9' � %!� Site Address: k 2.50Ci.41 14,4/5 /117
Tenant: Suite #:
J
Resident/Owner
2)
Name: J? . y� CL IC('ItC Phone: l% / 3/5- '(7 el .7-...
Address / City / Zip: "-q `f 3C — %�9/.( 1-) ✓aC
Contractor
Name: +-.5-e- %t 4 470Y �i.vt.t. .. ,int., License #: q �.2
Address: /v W d g- ,/1/,? City:
State: /vJ Zip: Ec4137 Phone: /, - g' '. Y$3
Contact: to , ,,r[. A ....„,e;'' Email:
Type of Work `
f
New X' Replacement Additional Alteration Demolition
Description of work: Lae / - ` ,4 6,---4-4-ode-1.4'U
NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City
Code. Please contact the Mechanical Inspector for information on permitted screening methods.
Permit Type
RESIDENTIAL
1 Furnace
COMMERCIAL
New Construction Interior Improvement
-I-- AirConditioner
_ Air Exchanger
Install Piping Processed
Gas Exterior HVAC Unit
Heat Pump
Under/Above ground Tank ( Install / Remove)
Other
_ _
RESIDENTIAL FEES
$60.00 Minimum Add or alteration
to an existing unit, includes State Surcharge
includes State Surcharge = $ i9 a , dd TOTAL FEE
$100.00 Residential New,
COMMERCIAL FEES
$60.00 Permit Fee Minimum
Contract Value $ x .01
= $ Permit Fee
$75.00 Underground tank installation/removal, includes State Surcharge
Surcharge = Contract Value x $0.0005
If the project valuation is over $1 million, please call for Surcharge
= $ 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 1 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 R b b -- i s s g e_k-t
Applicant's Printed Name
FOR OFFICE USE
Required Inspections:
Underground - Rough In
Reviewed By:
Air Test Gas Service Test In -floor Heat
Date:
Final HVAC Screening
!"
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