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3672 Denmark AveCity 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 EA080185 10/02/2007 ePermit Site Address: 3672 Denmark Ave Lot: 3 Block: 12 Addition: Timbershore 3rd PID:10-76502-030-12 Use: Description: Sub Type: Work Type: Description: e - Furnace Replacement Fumace Comments: Quesetions regarding elec 952-445-2840 Ashley Orman 410 W Lake St 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: Standard Heating & Air Conditioning 130 Plymouth Ave. N Minneapolis MN 55411 (612) 824-2656 - Applicant - Owner: Cheryl A Vaughn 3672 Denmark Ave 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 4011 C!tyofEa�ail Date: 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 a APR 1 1 2011 Use BLUE or BLACK Ink. Permit #: Permit Fee: Date Received: Via, tot( 1 Staff: CCS 2011 RESIDENTIAL BUILDING PERMIT APPLICATION - - l I Site Address: -3 to 7 2 bco vvwa 1✓ Unit #: RESIDENT / OWNER Name: CS) e_.4-•-/ I va.,[..t_sj In e> Address / City / Zip: (.o-7 Z. &Ail vV 4 k- A-ve- Applicant is: Owner X Contractor Phone: CoG-1.4f52, /L/27 50,0 /��Ir�9 s5-123 TYPE OF WORK Description of work: a---(16-1-et rc(risi 5le, ss doers / cei1.et k2-0 Idea Construction Cost: ,Df`t 0 Multi -Family Building: (Yes / No ) CONTRACTOR Company: Trot glu Prokssl�ct(5tryc<<s LLc-Contact: (r)s+e-kiC(od( Address: $-$S7 'grrc,v)6061 State: MN( Zip: GS -0 '7 (o License #: Zip (d 3 09 -TS bri v‘C City: <f viJGr l>r,oye—Fie-11'1,4s Phone: (o, 5- 1 > S©U (oSSt) Lead Certificate #: prT— —1 !® S3'3 -1 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: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: 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.gol herstateonecall.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 appraval of plans. Applicant's Printed Name Applicant's Signature Page 1 of 3 `Deli l % Pfl�. DO NOT WRITE BELOW THIS LINE 730 SUB TYPES Foundation Single Family Multi 01 of _ Plex Accessory Building WORK TYPES New Addition 7 Alteration Replace Retaining Wall Fireplace Garage Deck Lower Level Porch (3 -Season) _ _ Porch (4 -Season) Porch (Screen/Gazebo/Pergola) Pool Storm Damage Exterior Alteration (Single Family) Exterior Alteration (Multi) Miscellaneous or, ,G (c Il.(:. etA' " s= pd 77, NFf pp -a-0 /01? 4 -/el Interior Improvement Move Building Fire Repair Repair Siding Reroof Windows Egress Window _ Demolish Building* _ Demolish Interior Demolish Foundation Water Damage *Demolition of entire building — give PCA handout to applicant DESCRIPTION Valuation rf t2 C% Occupancy Plan Review 1 Code Edition (25%_ 100%4) Zoning Census Code Stories # of Units Square Feet # of Buildings Length Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) %?4r - Foundation rev Drain Tile Roof: _Ice & Water _Final Framing Fireplace: _Rough In Air Test Insulation Sheathing Sheetrock Reviewed By: Final MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Meter Size: Final / C.O. Required Final / No C.O. Required • HVAC Gas Service Test Gas Line Air Test Other: Pool: _Footings Air/Gas Tests _Final Siding: _Stucco Lath _Stone Lath _Brick ▪ Windows 1' pets P D o Retaining Wall: _ Footings _ Backfill _ Final Radon Control Erosion Control Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Pte, 5)(2,o /6)0 X' 2,00 Noe) 5,00 Poo" - Page 2 of 3 fe. Qazi Nzi ,,..� ' O °30 " Otacs 1-7 ;A; _1 , L fre7 ,5 2,0 /We-4'Jc Ct 6( rL9 0 tu4.014 r:j ( cuae incvre .4•7‘ eh/te?, fl1 ";t Jul 28 2014 09:46AM HP FaxGates G.C. 7634987710 4401Cil of hp Date: 3830 Pilot nob Road Eagan MN 5122 Phone: (65 ) 675-5675 Fax: (651) 75-5694 i"' page 5 Use BLUE or BLACK Ink For Office Use Permit#: �1,(���� Permit Fee: 3 J t o Date Received: 7/0S-1/ Staff: 014 RESIDENTIAL BUILDING PERMIT APPLICATION Site Address: ;i461 3c 7a 3672 �t�►r 1"6 v i ?l J ! Unit #: J Resident! Owner Name: •r- 4-11Yj�� /1'/2'0r- A .� Phone: L � y - ,' 72. Address / City / Zip: -'e... Aga /- Applicant is: Owner Contractor T of Work Description of work: ' !'i- 7 "` Ot-f.�- �'' Construction Cost: iO 2-r4'4- / 2 ' Multi -Family Building: (Yes v / No ) Contractor Company: ! Cr :_,eYc c,ir°' L-''' Contact: 47,1. -'r i r�,_ ' 1�; /, . ,f f _. Address: .7 • - - , .;;; F-%4.:- _ City: / • State: �M�1' Zrp ' Phone: oi?_Ty •G3y .� i,,_1• 7.9 ?� .a-,y,;f.,' c',_�y..<:%... Zip: e: ...� � Email: -C. = , License #: 1-7-';':-- Lead Certificate #: /%% If the project is exernpt from lead certification, please explain why: (see Page 3 for additional information) In the last 12 month, _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, dale and address of master plan: Licensed Plumber: Mechanical Contractor: Sewer 8 Water Contractor: Phone: Phone: Phone: NOTE: Plans an( the information] - ► supporting documents that you submit are considered to be public information. Portions of 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 (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.eooherstateonecall.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 1 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 w orized by a building pe It issued In accordance with the Stinnes . ing Code must b completed within 180 days rmlt suanc p. x_L Ce--- Appli a Printed tame Applicant's Signature Page 1 of 3