4581 Horizon CirCity of Eaau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
2010 RESIDENTIAL BUILDING PERMIT APPLICATION
//68/ 74gizzy.4
Date: L/11/A)
� Site Address:
Tenant: e-A4 / 5 km
I hereby acknowledge that this information is complete and accurate; that the work will be in conformanc
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not
accordance with the approved plan in the case of work which requires a review and approve.
Use BLUE or BLACK Ink
Permit #:
Permit Fee:
Date Received:
Staff:
RESIDENT / OWNER
TYPE OF WORK
CONTRACTOR
Name: ! °j S /
Phone:
Address / City / Zip: `J ( e n gl ?_
Applicant is: Owner "Contractor
Description of work: - -60
Construction Cost: Multi- Family Building: (Yes,/ No )
Name: L 1 5e4fll v/ t7bnSti„ License #:
Address: /7D- Aifji etAff. City: fr 1C°, //
�6 V Phone: �l /Z' X70 O
State: r /!r' /V Zip: � 7 � 7
Contact: (C 7 — Email:
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:
NOTE. Pl ans and supporting documents that you submit are considered to be public information. Portions of
the information m ay be classified as non -public if you provide specific reasons that would permit the C ity
conc/ud they are trade secrets.
Suite #:
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
Applicants Printed Nam
ants Signature
�-- th the ordinances a codes of the City of
art without a permit at the work will be in
Page 1 of 2
o n . irra
WATER SERVICE PERMIT
o1 ,
Kamm Rood PERMIT NO.:
* 857.E ` DATE:
Zoning. r No. of Units: f
Owne i, 3, ..: a= y e t }f. ( s
address:
Site Address: 3 :c r _r zo :. C r c l c L 1; 10 e s '.ter 1_. V
Wumber ',. 1: ,_.<; x.c (:.. ric' san PLS.';
Meter No.: Deposit:
C D
Size: Account onnection C harge ` >,u
ep : ).r i ni Permit:. I r r - 0.
Reader No.: �ti fi . r n . el
agree to comply with the City of Eagan Surcharge: 5
Ordinances. Misc. Charges: `7` ...r1 e ',:r '
Total:
Dote Paid:
Date of Insp.: / Z 3 — $ / Insp.: -
CITY EAGAN ' SEWER PERMIT
.,
3795 Not Knob Re PERMIT NO.- 5029
Eqggis, MN 55122 DATE: 12121/81
Zoning: RIV No. of Units: lk duplex
o wner; Joseph M ller Construction
t
Address:
Site Addritiff 458 o Cir L174131OP Mar East TV
pl um b er: Marty's 1 (Erickson P4.bg)
12/21/81 284 2 100.00 pd
1 agree to comply wilIb iltit c Eagan Co iol 425_ 00 pd
Ordinances. ccott%eposit:
\
1,... Permi Fee: 1,0_ 00 pd
)
4 °Surcharge: .50 pd
By ( 4/ . .,29--- - , Misc. Charges:
Dote of nsp • Total:
Insp.: / Z2 5— 7/ Date Paid: I ,
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA133030
Date Issued:09/18/2015
Permit Category:ePermit
Site Address: 4581 Horizon Cir
Lot:17 Block: 01 Addition: Ches Mar East 4th
PID:10-17153-01-170
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 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
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.
Contractor:Owner:- Applicant -
Charles Remy Iii
4581 Horizon Cir
Eagan MN 55123
Applicant/Permitee: Signature Issued By: Signature