3987 Fawn Way*'
City of Etall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
c�
Use BLUE or BLACK Ink
c.
Permit #: 9995 7
Permit Fee: 1AP(l 7 50
Date Recefd: 9-6 - /1
Staff:
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit #:
RESIDENT /
OWNER
Name: Phone:
Address / City / Zip: .3 985— /cq LA./ A./ kr. 47 -..`,--;:;07,1A--.) 5:3-/ 2
Applicant is: Owner aC Contractor <, l_ u R#39r)
TYPE OF WORK
Description of work: ge)O
Construction Cost: / 2, 60 6 Multi -Family Building: (Yes X / No )
CONTRACTOR
Company:41E4M (c. R (-‘0,)il
g0,) Contact: V..� WE P ^ME-$
Address: /7549, 0_01.,x4/27 O t e.. C City: (Cc� `J
State: i)tJ Zip: '5�-7+ Phone: 7 c2 _- Li2,6 3/0-.2
License #: QO/ 599 17. Lead Certificate #:
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
In the last 12 months,
No If
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan issued a permit for a similar plan based on a master plan?
yes, date and address of master plan:
_Yes
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
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 specificreasons that would permit the City to
conclude that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One CaII 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, -•• 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
Applicant's Printed Name
x
Applica ' 's Si =ture
Page 1 of 3
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675-5675
www.ci.eagan.mn.us
PERMIT
City of En
Permit Type:
Permit Number:
Date Issued:
Permit Category:
Mechanical
EA092070
11/18/2009
ePermit
Site Address: 3987 Fawn Way
Lot: 21 Block: 01
PID:10-20200-210-01
Use:
Addition: Deerwood Townhomes
Description:
Sub Type: e - Furnace
Work Type: New
Description: Furnace
Comments:
Quesetions regarding elec
952-445-2840
Judy Mayer
8910 Wentworth Ave S.
cal permit requirements should be directed to Mark Anderson, State Elec
cal Inspector,
Fee Summary:
ME - Permit Fee (Replacements)
Surcharge -Fixed
$50.00 0801.4088
$0.50 9001.2195
Total:
$50.50
Contractor:
Sedgwick Heating & Air
8910 Wentworth Ave S
Minneapolis MN 55420
(952) 881-7739
- Applicant -
Owner:
Stewart D Walker
3987 Fawn Way
Eagan MN 55122
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
Applicant/Permitee: Signature
Issued By: Signature
SEDGW1CK HEATING & AIR CONDITIONING CO.
8910 WENTWORTH AVENUE SOUTH UTJ%�
TH�••MIINNEAPOLIS, MN 55420 • (952) 881-7739 �
ADDRESS 8 7 I > > th J CITY 4.�A' 4 [ ,Q� "
OCCUPANT OWNER �crl FC,G O- ab4-1_4� 23 LUOg
INSTALLED BY DEC`l�
HEATING
TEST RECORD
JOB NO `6)(r
SOLD BY Ce444
MAKE
SERIAL NO
tietuifoY
5 > Q/
THERMOSTAT VP fkX)/
VALVE J�14, r"
LIMIT )(ail
LIMIT SETTING if2r /v
FAN SETTING / ► :CC'N
PILOT TYPE
IGNITION MODEL
Lev1/'1(.2)c
PILOT TIMING `r^
PRESSURE
INPUT CFH
STACK TEMP.
l4
PERCENT CO2
PERCENT 02
PERCENT CO
dk
MODEL
Lb -/o l 1141°1/36F m 7/
INPUT v/CY 400./
VENT SIZE N
TYPE OF LINER 13 p (et.,`?-
LINER SIZE ll/
FILTERS- SIZE 66' - 7t/ NUMBER /
WIRING
TEST TAG
LIGHTING INST
DATE TESTED " -07
COMPANY TESTING
NAME OF TESTER
FORM 235 (REV. 6/08) FORM DISTRIBUTION: WHITE COPY - JOB FILE YELLOW COPY - CITY
City of Eaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
r
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee:
Date Received:
Staff:
2013 RESIDENTIALgBUILDING PERMIT APPLICATION
Date: 00-3/76/Z
�c 3/7bl-� Site Address: / e 573 3.7 F-414)Li/1-'7 Unit #:
Resident/
Owner
Name: p ptdta /Ow,df(/tt- /1- - Phone:
Address / City / Zip:
Applicant is: Owner Contractor
Type of Work
Description of work: OC7 i41f 4 C 0-c O -JT
Construction Cost: Multi -Family Building: (Yes / No )
Contractor
140 A-, 6 fe J etvr--
a-. � &i6- Contact: . -{fit t-6- 60 1 J4
Company: /e)-21.4- �
Address: ?I 7 S - 'tri $7 ' .iL %- City: (..)f 7 ff- Q :(c . _
State: /1 /v Zip: //0 Phone: 76 3 € 20 ' 1i 6 7
License #: /6 C ‘61 Gq v Lead Certificate #: S 6C fs 6-Gat,.J
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
8 4---T- (778 0.7?6 z--49,,
In the last 12 months,
Yes No If
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan issued a permit for a similar plan based on a master plan?
yes, date and address of master plan:
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
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.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 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 autho ized by a building permit issued in accordance with the Minnesota State Buildin. •de must be completed within 180
days of per *ice,�
Applicant' signature
Page 1 of 3
Date:
City of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
-398'7
Use BLUE or BLACK Ink
r
For Office Use
Permit #: /d3 (f)&
Permit Fee: /c0 �./ O2.
Date Received: !P' ! 6 —734-
Staff:
74-Staff:
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Site Address: 3r8,7
Resident/
Owner
Name:
Address / City / Zip: 3 n 7
Phone:
Unit #:
Applicant is: Owner X Contractor
Type of Work
Contractor
Description of work:
Side l/vi nG1Uws
Construction Cost: 4. LS--GGci Multi -Family Building: (Yes / No )
Company: /TMc/',2�0�� Je
Address: mR 17
Contact:
State: /%VZip: SSG) Phone:
City: 101,-k
%),-5'/7J73Email:
License #: G k2 /1/ �G 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:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
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.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 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 must be completed within 180
days of permit issuance.
x 7(` / 61
Applicant's Printed Na
x
Axpplican Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA179261
Date Issued:09/26/2022
Permit Category:ePermit
Site Address: 3987 Fawn Way
Lot:21 Block: 01 Addition: Deerwood Townhomes
PID:10-20200-01-210
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:
This permit shall be null and void if work does not start within 180 days of issuance, or if work is suspended for 180 days or more after
started.
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 -
Mary L Titus
3987 Fawn Way
Eagan MN 55122
Renewal Andersen
1920 County Road C West
Roseville MN 55113
(651) 264-7052
Applicant/Permitee: Signature Issued By: Signature