3467 Greenwood Ct SCity 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
EA077170
04/03/2007
ePermit
Site Address: 3467 Greenwood Ct S
Lot: 4 Block: 18
PID:10-73000-040-18
Use:
Addition: Surrey Heights 1st
Description:
Sub Type: e - Furnace
Work Type: Replacement
Description: Furnace
Comments:
Quesetions regarding elec
952-445-2840
Diane Trinka
1770 Gervais Ave.
cal permit requirements should be directed to Mark Anderson, State Elec
cal Inspector,
Fee Summary:
Valuation: 6,400.00
ME - Permit Fee (Replacements)
Surcharge -Fixed
$50.00 0801.4088
$0.50 9001.2195
Total:
$50.50
Contractor:
Perfection Heating & A/C
1770 Gervais Ave
Maplewood MN 55109
(651) 777-7620
- Applicant -
Owner:
Mortgage Electronic Registration Syst
10790 Rancho Bernardo Rd
San Diego CA 92127
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply
of Minnesota Statutes and City of Eagan Ordinances.
h all applicable State
Applicant/Permitee: Signature
Issued By: Signature
Aug 1, 2012 12:36PM Sela Accounting No 1661 P 7
City of Eaall
3830 Pilot Knob Road
Eagan MN 66122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #: L E-67
Permit Fee: J:2,--Y-4:)-
Date
y 2 -Date Received:
Staff:
J
I % 2012 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: / I / 1 2- Site Address: 310, 3Li4,5-3(/0 3M9 Greenwood C+. S Unit#:
RESIDENT /
OWNER
Name: `j\.t.rYC'f 1-A-t1tc\- S l ra.,:> -\\ tome. O Gb C. Phone: ‘15:;2 -&&.31-1 ;,13 .>'
J (MV -t.„ Ca ' t_; -}so 0, r
Address/City/Zip: 0113;- C--1.'‘) LAc's{- (fur- -L y
Applicant Is: Owner X Contractor £��' n per.\`r a i Yh n S r 3 (-) LI
TYPE OF WORK
Description of work: re 'Coo t�
Construction Cost: 1 r. O'1 ST DC) Multi -Family Building: (Yes n / No )
CONTRACTOR
Company: r5' --1C1, L -,0 h c d. IVY) LKi'r l t ✓k et Contact: '`CVA
Address: MICU txCt k St U r e5f. LUL Park_
\ V c� City: �, �l15 (- rk_
State: MY\ Zip: G55'-)1 G, Phone: q CJS- 1 15 -- —) 1--
License #: G tit. OD \ D 50 Lead Certificate #; 11/A T.— a J 03 L/ — 1
If the protect is exempt from lead certification, please explain why: (see Page 3 for additional information)
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: Phone:
Mechanical Contractor:
Sewer & Water Contractor:
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, CaII Gopher State One Call at (051) 454-0002 for protection against underground utility damage. Call 46 hours
before you Intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq
1 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.
Exteriorwork authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days off permit Issuances „
Applicant's Printed Name
Applicant's Signature
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