877 Ivy LaneCity 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
EA077359
04/17/2007
ePermit
Site Address: 877 Ivy Lane
Lot: 10 Block: 1 Addition: The Woodlands North 3rd
PID:10-75892-100-01
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:
Duane M Lysholm
877 Ivy Lane
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
Cit of Eakall
410w
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use CC_
permit#
Permit Fee: /6-
)--
Date Received;
Staff:
2016 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 1 6
Resident/
Owner
Type of Work
Contractor
Site Address: 977 1 V*_f L4..J e- Unit #:
5 /4 L -An
Name: r) 1Q/4.1 Phone 14'ile'/C4—"Q
Address / City / Zip; ca Wvali-e4 5-S- 12-3
Applicant is: Owner Contractor
TZ4142*F
Description of work:
Construction Cost: 25, Li 7 0
Multi -Family Building: (Yes 't / No
(00‘^-1tigi./2. ftet.-
Company: Si-rinc..-intvg Contact:
Sles-t r4 -
Address: SI LAS- 1 rt 1 City: r14 -CLC.-
soN1
State PI
Zip: 55351 Phone: /65-417/- FA/VILA
_
(kik
License #: 4775 Lead Certificate #: 14-F-441-- 51-851 —
the project is exempt from lead certification, please explain why:
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: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
Fire Suppression Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered(0 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 the 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,00nherstateonecatl.orq
I hereby acknowledge that this information is complete and accurate, that the work wit 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 Sta B 'Iding Code must be completed within 180
days of permit issuance.
4
Applicant's Printed Name
x
Applicant's Signature
Page 1 of 3
City of Eagan
PERMIT
City of Eaan
Permit Type: Plumbing
Permit Number: EA137864
Date Issued: 07/27/2016
Permit Category: ePermit
Site Address: 877 Ivy Lane
Lot: 10 Block: 01 Addition: The Woodlands North 3rd
PID: 10-75892-01-100
Use:
Description:
Sub Type: Residential
Work Type: Replace
Description: Water Heater & Water Softener
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:
Bruckmueller Plumbing Inc
3992 Pennsylvania Ave
Eagan MN 55123
(651) 686-6696
- Applicant -
Owner:
Duane M Lysholm Tste
877 Ivy Lane
Eagan MN 55123
(651) 456-5448
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