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1635 Walnut Lane CITY OF EAGAN Remarks Addition Wood ate lst Addition Lot 13 Qik 5 Parcei 10 84600 130 05 Owner Street 1635 Walnut Ln. State Eagan, MN 55122 r • IdF-L/';- , Impr vement Date Amount Annual Years Peyment Receipt Date STREETSURF, STREET RESTOR. PAID GRADING SAN SEW TRUNK 1974 5 PA D * SEWER LATERAL WATERMAIN ir WATER LATERAL 197 5 15 * WATER AREA * STORM SEW TRK 975 * STORMSEWLAT q 1975 2036.55 135.77 15 PAID CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 130.00 10204 3-18-74 BUILDING PER. SAC p 10204 3-18-74 PaRK RE5IDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD - 55122 ~ 2:J 651-681-4675 New Construction Reauirements RemodellReoair Reauirements • 3 regislered srte surveys showing sq ft of 104 sq. fl. of house; and all roo(ed areas • 2 copies of plan (20°/, maximum bt coverage allowed) • t selof Energy Calcutations for heated additions . 2 copies of plan showirg beam 8 wintlow sizes; poured found design, etc.) • 7 site survey fa exterior additwns & decks . 7 set o( Energy Calwlations • 3 copies oi Tree Preservation Plan if lot plaried after 711193 • Rim Joist Detail Options selec6on sheet (bldgs with 3 or less uniLS) DATE 7 Lo/ VALUATION (EXCLUDING LAND)~`~ 7~,3, Ov JOB SITE ADDRESS ZAJ~e2 IF MULTI-FAMILY BUILDING, HOW MANY UNITS? , PROPERTY OWNER E' TYPE OF WORK S FIREPLACE(5)XO ,/1, 2 3 APPLICANT o, l) • PHONE # ~r72_W~7 ADDRESS\~ ?OID ef• 4-~hTl v~J• ; Sl~(/ ~De~' ZIPCODE5-!Sf I PAGER # - CELL PHONE # FAX # 9S2 - q~3 -~roDp NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY ~ Energy Code Category _ MINNESOTA RULFS 7670 CATEGORY 1 I (check one) - Residential Ventilation Category 1 Worksheet Submitted Energy Envelope Calculations Submitted I MINNESOTA RUI,ES 7672 - New Energy Code Worksheet Submitted Plumbing Contractor: Phone Plumbung Systein Includes: Water Softener Lawn Sprinkler I'ee: $90.00 Water Heater IVo. of R.I. Baths Nc, of I3aths Mechanical Contractor: Phone # l4echanical System Inchides: Air Conditioning I'ee: $70.00 Hea[ Recoveiy Syslem Sewer/Water Contractor: Phone # All above information must be submitted prior to processing of application. 10 I hereby acknowledge that I have read this application, state that the information is cor ct, and agree to compi with all applicable State of Minnesota Statutes and City of Eagan Ordina ces. y Signature of Applicanf Certificates of Survey Received _ Tree Preservation Plan eceived ~ Not Required , Updated tl01 REVEWAI, BY ANDERS$N RESIDENTIAL 350-73xn avE. rrE. BUILDING PERMIT APPLICATION FRDLEY; MN. CITY OF EAGAN ~9 9 763/502-4777 3830 PILOT KNOB RD - 55122 LICENSE# 20130983 651-6874675 NwrConsWelionRwWnmenb )-A 1; U V ~ RwwMftwirReauNmmb • 3 repbiered sie auvays shvAip p. R. of bt, eq.1L ot fwuse; and all roofad araas • 2 copbs al qan (20%mazimun bf caverage allowed) . 1 setof Energy Cakulations forYaeted additians . 2 capiea of plan afwwiig baem 8 wbdaw sizea: powed found daig(k ek.) . 1 sAe survey for eAedw adMione E decks . 7 sN d Eneyy CdcUetlas . Indirata Y Mme snved b1 septlc ryslan (or additians . 3 capMs of Troe Wetervation Ran Y bl plelled aller 717193 . Rim Jdst Delail Oplians seledbn sheet (Mdgs wIN 3 a less unAs) DATE (y •3V'tta •OI VALUATION .3. tI SS2E~- JOBSITEADDRESS.JL:i"Is C_XQr1d J[iMa, IF MULTI-FAMILY BUILDING, HOW MANY UNITS? PROPERTYOWNER~,B~ Q~ ~ TYPE OF WORK • % Yi ~ FIREPLACE(S) _ 0_ 1_ 2 APPLICANT •~`C~ rLIau-SCffiA,ci PHONE# 9.59•"145 •W4- ADDRESS 11c10 t a11~ ~1I?Ylt n'1l\:) ZIPCODE PAGER # CELL PHONE # FAX # IVEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY Energy Code Cateyory _ MINNFSOTA RULFS 7670 CATEGORY 1 (check one) - ResidenGal VenfilaGon Category 1 Worksheet Submitted - Energy Envebpe Calculations Submitted _ MINNFSOTA RULES 7672 - New Energy Code Worksheet Submitted Plumbing Contractor: Phone N: Plumbing System Includes: _ Water Softener _ Lawn Sprinkler Pee: $90.00 _ Water Heater No. of R.I. Baths _ No. of Baths Mechanical Contractor: Phone # Mechanical Syscem Includes: _ Air Conditioning Tee: $70.00 _ Heat Recovery System Sewer/Water Conhactor. Phone Ik All above information must be submitted prior to processing of application. I hereby acknowledge that I have read this application, state that ihe information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordin nces. SlgnaFure of Appllcanf i tQ/1l.LycAYZ Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ uPaaree 1roi VILLAGE OF EACAN WATER SERVICE PERMIT 3795 Pilot Knob Road PERMIT NO.: 1478 Eogon,MN 55122 DATE: 5/29/4 Zoning: R-1 No. of Units: ~ Owner: Ne,w_yp ' Address: 13- S GY / ~ ~ Site Address: _1635_Wd1nu~I nn Plumber. _Thom son Plumbinq Co. Meter~ N,~o-.~:~~O!7~G OoZ ~'54 Connection Charge:l3Q_._0O Dd 3/1Q Size: 8 • Account Deposil: Reader No.: Permit Fee: 10.00 billed 29/4 I ogree to complr with t6a Villoge of Eagan Surcharge: • 50 bllled 2-9/4 Ordinancas. Misc Charges-"~d•O n '~r r Total: BY Date Paid: Date of Insp.: Insp.: YILLAGE OF EAOAN SEWER SERVICE PERMIT 3795 Pilot Knob Rood PEHh11T NO.: 2236 Eogon, MN 55122 DATE: 5/29/74 'Laning: R-1 No of Units1 Owner:New HOrizon Homes Address: Site Address: 1635 Walnut Lane Plumber: Thi]mpcnn Pl nm} i na Cp. I ograa fo comply with fha Villoge o4 Eogen Connection Charg00.00 pd 3/18/4 Ordinoncas. Account Deposit: Permit Fee. 10.00 billed 5/29/4 Surcharge: • 50 billed 5/29/9 BY: Misc Charges: Da[e of Insp.: Taml: I nsp.: Dale Paid: CITY of EAGAN N° 3223 ? BUILDING PERMIT ~ 3795 Pilo! Knob Road • Owne: ~ Eagan. Minaesola 55112 Addreu (preaeni) ..ls~-~.`.. S.("d 7~3 454•6100 Buildee . _51_ ld- - 7 T Dah Addtew DESCRIPTION Btoriu To Bs Uud For Front Deplh Hoig6! Esl. Cos! formit Foa Aomarb LOCATION Slrsel, Roed or oiher Desertpiion ot Loealfon I Lo! Bloek Addtifoa or Tr~e! Thia permit doex not aulhorise !hs use ot fireefs, roada, ¢lleps or sideweliu nos does if give fho owner oe hL aqoe! the righf to ereate anp aituafion which is a auisanes or whieh preseafs e 6ssard !0 the henlih, sefely, eonveaioap snd geaeral walters !o nnpona in the communify. THIS PEAMIT MUST BE KEPT ON THE PREMISE WHILE THE WOAR IS IN PROGAESS. ihis L !o eertif9, ihai... y.~~..r..•°--.~..........has permissioa !o Orec! a..... ~ ~ - .`Q"."P~.`.J............_upon the above dqscribed premise subjeat to !he provisions of all applicable Ordinances fos the Ciiy o Eagen r )4:........ Par BuLildin Ma r Q Impoclos ~ VILLAGE 0'r' EAGAN 3795 Pilot Knob Road Eagan, Nlinnesota 55122 PERPqIT NO.: 516 The 4illage of Eagan hereby grants to Geo. Sed(Twick Heatina of 1001 Xenia Ave. So. a rx~nmTNr. Permit for: (Owner) New Horizon - 4loodgate at6ZZ)ti 16a1 walnut i,ane , pursuant to application dated 5/8/74 , Fee Paid: S40_00 dated this 31st day o£ t7ay , 1974 1.00 . Building Inspector Mechanical Pexmits: did Totalc ~ /D ~Y,~oo 13 0 o s 'cITY oF rAG:aN Zv, f 3795 Pi1ot Knob Road Eagar., D'iinnesota 55122 PERtiST NO.: 442 ~The City of Eagan hereby grants to ThomPson Piumhin.^, Co. of 12201 M.inBetOr,yR R1vA. a PLrTMpiNG Fermit for: (Owrter) ?'ew Nor.izon ?'omes - 9'eod!?ate Addn. 1 at sec atrached list , pursuant to application dated 4/19/1= , Fee Paid: $1,060.00 dated this 24r1l day of P.Fri.l , 19 74 4?.00 e/c Building Inspector Mechznical Permits: Bid Total: ~ r EAGAN TOWNSHIP DALE S. PETERSON Budding & Ubliry Inspector PUBLIC WORKS DEPT. wiLunM H. sRnrvcH 3795 PILOT KNOB ROAD Supenntendentof PubbcWOrks EAGAN, MINNESOTA 55122 PtiONE 450500 Pcrmit :'o. 442 - 4/24; 7n Covers `o1lo;ainq units and homes: 1039,1532. 1636, 1640, 1644, 1e50. 1G54, 1058, 1662, 166f, 100; 1571, 107'3. 1rn2, 168F, lr.rnn, lc^2, lAnn, 1690, lr°:2, 1700 Walnut Lane and ].F35 1655. 1(a1, 1065, 1669, 1E73, 1677, 1.r81, IFR5, 3689, 1593, 1EC7, 1_701 walnat Lane 1031-'Q-27-25 Hi.chory I!ill, ]«,(-F,R/F[ickory (iill & 1667-05 'rlickor.y Lane, 1665,07-00-71 fiir_}:or, Hi11, 1601701-59-57 Hirkory ]ti71, 1697=83=85=57 I?ic};arc Ilill plus last el.even ( i 1) town;:r,use buitr'.i.nc7s - do not have cor.rect house nur.Qiers as vet. HOUSE HEATING TEST RECORD D-21121 ADDRESS 1635 Nalnut Lane APT. -FLOOR CITY SUBURB Eagan OCCUPANT Bert F. Merfeld OWNER YB9 HEAT LOSS DATE HTG. INST. GAS C0. METER BADGE iY SOLD 8Y INSTALLED BY Sed¢wiCk Ht2, Elsctrical Work By Gas Line By lr 11 TYPE OF HEAT GA _ FA X HW STEAM SPACE HTR. UNIT HTR. -OTHER GAS DESIGN CONVERSION MAKE WilliflmsoL MAKE OF BURNER Model 1117-10-5 Model Serial 7421109 Max. BTU Rating INPUT 10 O~000 Btu.4i2'_ MAKE OF FURNACE Model CONTROLS THERMOSTAT Cm 280 Heat Plug Vent Size 4" Valre M A V80 KIND OF LINER Al~• SIZE 611 NONE Limit abahaw 750n Draft Hood Vertical Regularor Limit SeNing 2000f Filters $izels" x 25" Numbar 1 Fon Setting 900f & 1200f Chimney Location Inside YQ$ Outside Pilot Type C'Ollple Chimney Consiruction Metalbeatoe Pilot Make Pilot Model Smoke Bomb Wiring Pilot Timing 68 Seconds Draft QK Test Tog Ye8 L.W. Cut Off Door Prassure Lighting Inst. YQe Pressure 4•4"W•C'• PercentCO2 8•0% Date Tested 10.426r74 p Percent OZ 7-)%- Campany Testing ~ Stack Temp. 550 f percenf CO 0•0~ Name oF Tester • Form 235 2000 BUILDINC PERMIT APPLICATION (RESIDENTIAL) cirr oF encari ~ •~i ) I~5-7~ 3830 P 55122 v~ 651-681-4675 h RemodeUReoalr Reaulrements New ConshucHon Reaulrertfen 30qa 7-3- G v > 3 reylatered flro wneys ehowiny fq.1t. of bf, sq. H. of house 2 coDles of plan and gy rooletl areas (40X maxlmum bt covemae allowe~ 1 set ol eneryy cdcWaNOns for heated addNlau > 2 coples of plans (show beam 8 wlndow suee; poured tnd. dealpn: etc.) t alte wrvey ior extedor additlona & decks > 1 set W enerpy calculaHona : J coples ol hee preservailon plan II bt ptattetl alter 7/1/93 DATE: (0 7'3 ~ ZCOC) CONSiRUCT10N COST: 9 DESCRIPTION OF WORK: ~ l STREETADDRESS: / "hhu4 -bqn-e LOT: ~ BLOCK: ~ SUBD./P.I.D. M: \,n)o_ Q1uqA k IS~ Name: A'~InSOn -D~111 i An Gelr~ Phone C f9 S~ ~9C~5 - 90,-) -7 PROPERTY Last Flrst OWNER Sheef Address: L)Al,-701 l ciri S?a?e: w1ti ztP: 5 S i~ a Company: Phone (area code) CONTRACTOR Sheet Address: License N ExP• City State: Zip: ARCHITECT/ ENGINEER Company: Name: Telephone ri: ( ) Sheet Address: Regishaflon C CNy State: Zip: Sewer/water licensed plumber (if installina sewer/waterl: Phone M~-) I hereby acknowledfle thaf I have read lhis applbafbn, sfafe fhat Ihe IMormafion is cortecfi, and agree to compty wifh a0 applieable State of Minneaota Sfatutes and City of Eayan Ordinanees. /j~~ Siflnafure of ApplicanY. OFFICE USE ONLY I,•~ . I , Certificates of. Survey Received _ Yes _ No i ~ Tree Preservation Plan Received _ Yes _ No ~ Not Required ' OFFICE USE ONLY BUILDING PERMIT SUBTYPES , ? 01 Foundation ? 07 OS-plex 0 13 16-plex ? 21 Porch (3-sea.) ? 31 Ext. Alt - MuRi ? 02 SF Dwelling ? 08 06-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 03 01 of _ plex ? 09 07-plex A 18 Deck ? 23 Porch (screened) ? 36 Muw ? 04 02-plex ? 10 08-plex ? 19 Lower Level ? 24 Storm Damage ? 05 03-plex ? 11 10-plex Plbg _Yor_N ? 25 Miscellaneous ? 06 04-plex ? 12 12-plex ? 20 Pool ? 30 Accessory Bldg. WORK TYPE ? 31 New O 36 Move Bldg. ? 43 Reroof ? 32 Addition ? 37 Demolish (Bldg)' ? 44 Siding ? 33 Alteration ? 38 Demolish (Interior) ? 45 Fire Repair p 34 Repair ? 42 Demolish (Foundation) ? 46 Windows/Doors ' Give PCA handout to applicant for demolition permit GENERAL INFORMATION SAC Code o I # of Stories sq. ft. No. of Units 0 Length sq. ft. No. of Buildings Width Footprint sq. ft. ~ Const. (Actual) Basement sq. ft. Census Code (Allowable) 5' Main level sq. ft. MC/ES System UBC Occupancy 1?--'?,> sq. ft. City Water Zoning 17. D sq. ft. Booster Pump PRV Fire Sprinklered MISCELLANEOUS INSPECTIONS ? Stucco/Stone APPROVALS Planning Building Engineering Variance PermitFee Valuation: g iZ0d,9-~ Surcharge Plan Review License MC/ES SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies .']5 Total: SAC Units % SAC - ~ : 52. 02 i , ~ .82 ' 12 .-66 _ ~ ---I I o ~`i -_o ~ 13196 ~ _ 2:6g - 9 " 20 0 ~2 -7 40 60 Feet voivfizuui tnu iz:ju rne 10J ari 4480 xnivnneL nreuvunx~niv WJ uuzi~uz. re - al BYANDERSEN' . 7une 7, 2001 City of Eagan 3836 Pilot Knob Roaci Eagan, NIIQ 55122 To Whom It May Concern: Elder 7ones is authorized to pull building permits for Renewal by Andersen_ Please allow Elder Iones to provide this service for us in Eagan. This authorization is vaiid FoT any date beyond 616101; untii a Renewal by Andersen manager expressly revokes it in writing to the City_ I requcst this authorization be accepted expeditiously, as to not delay in ihe processing of our building pcrmits any further. Plcasc call mc if thcrc uc any questiuns. I can Uz contacted at 763-5024706. ' Your immcdiate attention to this mattcr is appreciated. Sincerely, Oond R. &Rau ation ivlanager Renewal by Andersen Corporatian ('r.~ Kara-F.lrie,r .Tnnec M:MYGGH:AID),A M. E L GAMAL oWy Fuaic ~tinnesota lpn Etpires ltn. at~ pppq Received Time Juo• 7• 1 07PM 2004 RESIDENTIAL BUILDING PERMIT APPLICATION V U City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 ~ Telephone #i 651-675-5675 FAX # 651-675-5694 L 0~'SI New ConsWCtion Reauiremenls RemodeVReoair Reauirements OKce Use Onlv 3 registe2d site surveys showing sq. il. of IoL sq. ft. of house; and all roofed areas 2 wpies of plan Cert of Survey Real _ Y_ N (20%maximum lol coverage allowed) 1 set of Energy Calalations for heated addilions Tree Pres Plan Recd _Y _ N 2 copies ol plan showing beam & window sizes; poured found design, etc. 1 site survey for addNons 8 decks Tree Pres Required _Y _ N lsetofEnergyCalalations Addmon-indicateBonsitesep6csystem On-siteSepUcSyslem _Y _N 3 copies ol Tree Preservation Plan i( lot platted after 711193 Rim Joist Detail Options selection sheet (bldgs with 3 or less uniLs Date Construction Cost "fZ )03J / r Site Address /~p ,~j 1 I L n.~ UniUSte # ~ Description of Work Multi-Family Bldg _ YX-PI. Fireplace(s) _ 04~1 _ 2 Property Owner Telephone k(~~ ) 90) Z~ p~,~ Contractor E tL~7 L ( ~ Address v (J~, NLJ l City 0,I//GA State Zip Telephone # P/) Z ) ,9 9d '0-)P COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 Mmnesota Rules 7672 Energy Code Category , Residential Ven4lation Category 1 Worksheet • New Energy Code Worksheet (V submissiontype) Submitted , Submitted • Energy Envelope Calculations Submitted Have you previousiy constructed a building in Eagan with a similar plan? _ Y _ N if so, 25% plan review fee applies. Licensed Plumber Telephone ) Mechanical Contractor Telephone Sewer/Water Contractor Telephone #I(U U C T ~ 5 2004 I hereby apply for a Residential Building Permit and acknowledge that the inforfnation is complete and ccurate; that the work will be in conformance with the ordinances and codes of the Ci4~f--Eagan- 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 'n the case work which requires a review and approval ofpl 1,10 ~ Applicant's Printed Name App canYs Signature 1~ j lu l-I ~O °c~ 2005 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construclion Revuiremenis RemodeVReoair Reauirements O(fce Use Onlv 3 regislered site surveys showing sq. ft. of lol, sq. ft. of house; and all roofed areas 2 wpies oi plan CeM1 of Survey Recd Y N (20°/, maxunum lot coverage allowed) 1 set of Energy Calculations lorheated additions Tree P2s Plan Recd Y_ N, 2 copies of plan showing beam 8 window sizes; poured found design, etc. 1 si[e survey foraddNOns 8 decks Tree Pres Required Y N lsetofEnergyCalculalions Add'Rion - indreafeAon-sResepticsystem On-sAeSepficSystem _Y _N 3 copies of Tree Preserva6on Plan if lot platted after7/1193 Rim Joist OefaJ OpSons selec6on sheet (buildings with 3 or less units) l Date Construction Cost e"l Site Address .46 jS UniUSte # DescripNon of Work Ple - ~_Cc`°'o Multi-Family Bidg _ Y2k, N Fireplace(s) _ 0 _ 1 _ 2 Property Owner ss vi Telephone ) Contractor AV,-e-~ C~~ w Address 7ss`3- SuAtZZg City Al lmm State ~-1 v Zip S~S q 7 ( Telephone f5 74 6 S43 - lzvo COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672 Energy Code Category , Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (J submission type) Submdted Submitted . Energy Envelope Calculalions Submitted , In the last 12 months, has the City of Eagan issued a permii for a similar plan based on a master plan? _ Y _ N If yes, date and address of masier plan: Licensed Plumber Telephone ) Mechanical Contractor Telephone ) Sewer/Water Contractor Telephone ) I hereby apply for a Residential 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 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. `~Cw 1 s Applicant's Printed Name Applicant's Signature 2006 RESIDENTIAL BUILDING PERMIT APPLICATION pi, City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New CorrsWction Reairements RemodeVFieoair Reauiremenls Olfice Use Onb 3 registered ste surveys shaxing sq R. of bt, sq fl. of house; and all roofed areas 2 copm of plan showing foohrgs, bmms, joisis Cert of Survey Recd Y _N (2096mazimumbtcove2geallowed) isetofEnergyCalculafionsforheatedaddihons TrcePresPlanRecd Y _N, 2 mpies of plan showirg beam 8 window s¢es; poured fouM design, ek 1 site survey tor addi Wm 8 decks Trce Pres Required Y _N 1 set of Eirergy Calculations AddNon - iridkafe if onsife sspfic sysfem On-sie Sepfic System _ Y_ N 3 oopies of Tree Preservation Plan if lot platted after 7/193 Wm Joist Defail Ophons selection sheet (buildvgs with 3 or less units) Minnegasco mechanical ventilation form Date Constructioo Coat ~S r ~Gfl SiteAddress /G35 w~ln~t ZMvt- uoiuste # Description of Work S/ ) ct i I'1 ~ 1.11 iI /1 clOW S^ O Muki-Family Bldg _ Y/N Fireplace(s) _ 0_ 1 _ 2 Property Owner ~6(f/A Telephoae # (G51) 90S - qD Z7 cootraccor ~ ~'?j'1 be~La~~ E~r?Or'S Address g~7 ~~tqlG ~Jd9G. ~~PRi~ City S~'/Uv°(~Pi^ stase /til/V ziP S So 8c, Telep6one #(,SS!) 43 9' -17 G 6 COMPLETE THIS AREA ONLY IF CONSTRUCTIN6 A NE1N BUILDING - Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672 Energy Code Category , ResideMial VeMilation Category 1 Worksheet • New Energy Code Worksheet (J submission type) • Submitted Submitted • Energy Envebpe Calculations Submitted In ihe last 12 months, has ihe City of Eagan issued a permit for a similar plan based on a master plan2 _ Y _ N If yes, dafe and address ot master plan: Licensed Plumber Telephone ~ Mechanical Contractor Telephone ~ Sewer/ Water Contractor Telephone # I hereby apply for a Residential Building Pertnit 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 pemilt, 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. ApplicanYs Printed Name ApplicanYs Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA119599 Date Issued:12/09/2013 Permit Category:ePermit Site Address: 1635 Walnut Lane Lot:013 Block: 005 Addition: Woodgate 1st PID:10-84600-05-130 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace & Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Diane Moyer Home Energy Center 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 - Daniel J Hanson 1635 Walnut Lane Eagan MN 55122 (612) 501-8385 Home Energy Center 2415 Annapolis Lane N #170 Plymouth MN 55441 (651) 766-6763 Applicant/Permitee: Signature Issued By: Signature