1544 Clemson DrCity 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
EA092446
12/30/2009
ePermit
Site Address: 1544 Clemson Dr
Lot: 8 Block: 01 Addition: Thomas Lake Heights 2nd
PID:10-75951-080-01
Use:
Description:
Sub Type: e - Fumace & Air Conditioner
Work Type: New
Description: Fumace & Air Conditioner
Comments: Quesetions regarding electrical permit requirements should be directed to Mark Anderson, State Electrical Inspector, (952)
445-2840
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:
Gerald A Meyer
1544 Clemson Dr
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
SEDGWICK HEATING & AIR CONDITIONING CO.
8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 • (952) 881-7739
ADDRESS 159 LlA
OCCUPANT
SOLD BY
MAKE
SERIAL NO
C a..)
HEATING
TEST RECORD
JOB NO 5.0o
CITY GA,J
OWNER
Mey��ti 1 AN * 2qQ�
INSTALLED BY
r 1
MODEL 6 01fW " h'A� 0
INPUT G o d
THERMOSTAT UPSID
P VENT SIZE
VALVE TYPE OF LINER If ey%
LIMIT LINER SIZE
LIMIT SETTING FILTERS. SIZE /6 ? S- y NUMBER
FAN SETTING WIRING SP l tr.h
PILOT TYPE (fl'/7'29. TEST TAG
4/9
IGNITION MODEL 1445,./7 LIGHTING INST.
PILOT TIMING �DATE TESTED5"1 — o -07
PRESSURE � • PERCENT CO2 COMPANY TESTING c.-5; 4.3 `<
INPUT CFH PERCENT 02
STACK TEMP. 3 '10 PERCENT CO NAME OF TESTER
FORM 235 (REV. 6/08) FORM TRIBUTION: WHITE COPY - JOB FILE YELLOW COPY - CITY
CITY OF EAGAN
3830 Pilot Knob Road
P. O.'3ox 21199
Eagan, MN 55121
WATER SERVICE PERMIT
PERMIT NO •
DATE:
Zoning: No. of Units.
Owner:
Address:
Site Address -
Plumber
Meter No.: Connection Charge.
Size: Account Deposit --
Reader No.: Permit Fee•
1 ogres to comply with the City of Eagan Surcharge.
Ordinances.
Misc. Chorges•
Total
By / Date Paid•
Date of Insp.: Insp •
CITY OF EAGAN
3830 Pilot Knob Road
P. 0. -Box 21199
Eagan, MN 55121
Zoning:
Owner•
Address•
Site Address -
Plumber
SEWER SERVICE PERMIT
PERMIT NO •
DATE -
No. of Units•
agree to comply with the City of Eagan Connection Charge•
Ordinances. Account Deposit -
Permit Fee -
Surcharge.
By Misc. Charges:
Date of Insp.: Total•
Insp • Date Paid•
41'City OfEwa
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 875-5694
Use BLUE or BLACK Ink
For Office Use Q
Permit #: I I (01 v 2
Permit Fee: 4(34 ' 1S
Date Received:
1 I o / 14 / V3
Staff: 017
2013 RESIDENTIAL BUILDING PERMIT APPLICATION q
Date:. -11- 13 ,55
Site Address:)„4.45 .: 155 S•�. � ` _-- $ nd
Name: /Or zit) 1'J ( 744,r) hot.ls_ Phone: 642. 72/- Trod
Address / City / Zip:
Applicant is: Owner Contractor
Description of work: Pubft F r+n v5.
Construction Cost:* %G 5, 900
Company: RA_C_ _Cc7Lasigtitvaiti Contact: 13elf8 Err. ee)
Address: 3 to 3 . M , S1etAck. city: Hlinnea polr``+S
Mufti -Family Building: (Yes No )
State: MAI r AI Zip: 5-5-110 6 Phone: _ 6/02. - ! 2-J- 5506
License #: rj t^ - i 9 Z 0 6 2- Lead Certificate #: NAT 2 41.5"7
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:
Phone:
Phone:
Sewer & Water Contractor: Phor
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.
Applicant's Printed Name
x
Applica s Signa
Page 1 of 3
City of Eapll
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use /�
Permit #: 02 ‘:/6')
Permit Fee:
Date Received:
Staff:
ii) -00
2015 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: L- C Site Address: L. l Q ury\"'yN.
Tenant:
Name:
Address / City / Zip:
am ,i 1 p ( L
Address`'[
State: ` Zip: `�Z-1 `p
Suite #:
Phone: W 51 L D t ` C
License #: l-0 Ll 1 -
WC -
L>1C� City:
Phone-S�CJlS iJ S/ Lo /
Contact Email: 1 1 0 IN r Li
(1e
New ND Replacement Repair Rebuild — Modify Space — Work in R.O.W.
Description of work:
RESIDENTIAL
Water Heater
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener (includes State Surcharge)
$60.00 Lawn Irrigation (includes State Surcharge)
$60,00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes State Surcharge)
*Water Turnaround (add $210.00 if a 5/8" meter is required)
$115.00 Septic System New (includes County fee and State Surcharge)
Lawn Irrigation (RPZ /PVB)
Septic System
New
Abandonment
ater Softener
Add Plumbing Fixtures ( Main /__ Lower Level)
Water Turnaround
TOTAL FEES $
CALL BEFORE YOU DIG. Cali 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 f
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.
L)
Applicant's Printed Name
AOR OFC' USE
Rei
x
Applican%s Signature
City of Eagan
PERMIT
City of Eaan
Permit Type: Plumbing
Permit Number: EA133019
Date Issued: 09/17/2015
Permit Category: ePermit
Site Address: 1554 Clemson Dr
Lot: 16 Block: 01 Addition: Thomas Lake Heights 2nd
PID: 10-75951-01-160
Use:
Description:
Sub Type: Residential
Work Type: Replace
Description: Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Fee Summary:
PL - Permit Fee (WS &/or WH) $59.00
Surcharge -Fixed $1.00
0801.4087
9001.2195
Total: $60.00
Contractor:
Owner:
Hong Thi
1554 Clemson Dr
Eagan MN 55122
- Applicant -
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.
Applicant/Permitee: Signature
Issued By: Signature
City of Eagan
PERMIT
City of Eaan
Permit Type: Mechanical
Permit Number: EA133032
Date Issued: 09/18/2015
Permit Category: ePermit
Site Address: 1554 Clemson Dr
Lot: 16 Block: 01 Addition: Thomas Lake Heights 2nd
PID: 10-75951-01-160
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.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Fee Summary:
ME - Permit Fee (Replacements) $59.00
Surcharge -Fixed $1.00
0801.4088
9001.2195
Total: $60.00
Contractor:
Marsh Heating & Air Conditioning
6248 Lakeland Ave N
Brooklyn Park MN 55428
(763) 536-0667
- Applicant -
Owner:
Hong Thi
1554 Clemson Dr
Eagan MN 55122
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.
Applicant/Permitee: Signature
Issued By: Signature
City of Eaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
RECEIVEr
JAN 1 1 2016
Use BLUE or BLACK Ink
For Office Use
Permit #: I't'1 1o(..p1
Permit Fee:(OO . 00
Date Received: I — "— 1 LO
Staff:0
2015 RESIDENTIAL PLUMBING PERMIT APPLICATION
Site Address: 15
Phonesn:
1t
Suite #:
J
License #: W 641376
ra to ` Address: 1801 50th St East
h 'Mn 55077 •651-451-224'
State:- Zip: Phone:
Contact: William R Milbert Email:
_ New — Replacement _ Repair _ Rebuild _ Modify Space _Work in R.O.W.
Description of work:
RESIDENTIAL
Water Heater
Lawn Irrigation L. RPZ / _ PVB)
Septic System
New
Abandonment
XWater Softener
Add Plumbing Fixtures L- Main / _ Lower Level)
Water Turnaround
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$60.00 Lawn Irrigation (includes $5.00 minimum State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
*Water Turnaround (add $200.00 if a 5/8" meter is required)
$115.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) /�
TOTAL FEES $ (t/ , O D"
CALL BEFORE YOU DIG. Cali 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.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 1 understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that thework will be in
accprdance with the approved plan in the case of wgrk which requires a review and approval of pla9s.
Itv'e, •
Applicant's Printed Name
Applicant' Signet re
:Rogwred
Miteri5elated