3677 Widgeon Way BCity 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
EA077310
04/13/2007
ePermit
Site Address: 3677 Widgeon Way 1B
Lot: 4 Block: 1 Addition: St. Francis Wood 3rd
PID:10-65902-040-01
Use:
Description:
Sub Type: e - Furnace & Air Conditioner
Work Type: Replacement
Description: Fumace & Air Conditioner
Comments: Questions regarding electrical perm
952-445-2840.
equirements should be directed to Mark Anderson, State Electrical Inspector,
Fee Summary:
ME - Permit Fee (Replacements)
Surcharge -Fixed
$50.00 0801.4088
$0.50 9001.2195
Total:
$50.50
Contractor:
Controlled Air
21210 Eaton Ave
Farmington MN 55024
(651) 460-6022 X253
- Applicant -
Owner:
Charles Schwartz Tste
3677 Widgeon Way 1B
Eagan MN 55123
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
City of Eqpt
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee:
qb
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone: (651) 675-5675
Fax: (651) 675-5694
Staff:
2012 RESIDENTIAL PERMIT APPLICATION
Date: 9 - /7 Site Address: M {-I 4"-e° -ea-- 161
Tenant:
2 .1
Suite #:
Name:
Address: / ke-r-e.e,
State:/2/ zip65 1/ 3
Contact:
a, v. -E...
License #: 4'0
City.
Phone:
Email:
New Replacement s Repair Rebuild Modify Space Work in R.O.W.
Description of work: .5
RESIDENTIAL
Water Heater
Lawn Irrigation ( RPZ
I Septic System
RESIDENTIAL FEES:
$60.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $560 State Surcharge)
I $60.00 Lawn irrigation (includes $5.00 State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $560 State Surcharge)
*Water Turnaround (add $189,00 if a 5/8" meter is required)
$105.00 Septic System New ($1060 per as built) (includes County fee and $5.00 State Surcharge)
New
Abandonment
P8/B)
Water Softener
Add Plumbing Fixtures Main / Lower Level)
Water Turnaround
TOTAL FEES
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. wwwoopherstateonecall.org
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 it; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of p ns.
x 04201,
e_Ce C711
Applicant's Printed Name
FOR OFRO' US
Required 1
Applicanrs Signature