1543 Greenwood Ct NCity 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:
Plumbing
EA088744
04/15/2009
ePermit
Site Address: 1543 Greenwood Ct N
Lot: 1 Block: 02 Addition: Surrey Heights 1st
PID:10-73000-010-02
Use:
Description:
Sub Type:
Work Type:
Description:
e - Water Heater
New
Water Heater
Meter Size Meter Type
Manufacturer
Serial Number Remote Number
Line Size
Comments:
Mike Skaja
2090 County Road 42 W.
Bumsville, MN 55337
Fee Summary:
PL - Permit Fee (WS &/or WH)
Surcharge -Fixed
$50.00 0801.4087
$0.50 9001.2195
Total:
$50.50
Contractor:
Tony's Appliance
2090 County Road 42 West
Burnsville MN 55337
(952) 435-2442
- Applicant -
Owner:
Jason W Dulas
1543 Greenwood Ct N
Eagan MN 55122
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
Aug. 1. 2012 12:37PM Sela Accounting No.1661 P. 15
City of Evan
3830 Pilot Knob Road
Eagan MN 65122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use (�
Permit ft: / J , 61
Permit Pee: c -'--f 7 •
Oats Received:
Staff:
1
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: S/ I /1 Z Site Address: (53°1,1 Sul 115113, )946 Green tel (2*. (l Unit #:
RESIDENT /
OWNER
Name•J .el \-,�}-s rw�%�o
i- , C. Phone: (1 5,::t -03 i —I 3 3
1 Pa 1 (rO� r cGt :k-y\e T-
Address / City / Zip: �tj 3iS CA -1-v LJe*i- A_k-L.l.'t �/
tr-,A1.fl c`('t;l�'r+\ v. 1 n'1 rl (:3 Li L/
Applicant is: Owner X. Contractor
TYPE OF WORK
Description of Work: re. coo C`
Construction Cost: 1A D • S—, (-X) Multi -Family Building: (Yes / No )
CONTRACTOR
1
Company: 6 c -l& Quo 1 vt1 d- R m r:d ei t v1 Contact: Kct r- t i–•
Address: Lit CU tXCt�1 Sl o r ( \ V 1City: 5t , L.bi-kis Pet r -t_
State: }rY\i'\ Zip: 55'11 U, Phone: C) 63:1.-9 1 5 -- —7c)rZ G
License #: C tit DC) 1 0 $ (, Lead Certificate #: ,1fAT — a 5 Lb 3 it — i
if the project 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. Cell Gopher state One call at (051) 454-0002 for protection agaInst underground utility damage. Ca1148 hours
before you intend to dig to receive locates of underground utilities. w.nv.00pherstateonecall.orq
I hereby acknowledge That this Information Is complete and accurate; Ihat the work will be In conformance with the ordinances and codes of the City of
Eagan; that I understand Ihls Is not a permit, but only an application for a permit, and work Is not to start without a pennll; that the work will be in
accordance with the approved plan In the case of work which requires a review and approval of plans.
Exterlor work authorized by a building permit Issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit Issuance.
x ) r 1 Yl & r 411
Applicant's Printed Name
x I�IAA.v` V Ct--
Applicant's Signature .
Page 1 of 3
4401`b
City of Eap
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
MAY 12 2015
Use BLUE or BLACK Ink
For Office Use
Permit #: ) 2) 0C)1
Permit Fee: 6)0_ 00
Date Received:"-) - t 1
11
Staff:
2015 MECHANICAL PERMIT APPLICATION
❑ Please submit two (2) sets of plans with all commercial applications.
Date: 5- Lel— I4, Site Address: i t - C51 CSG C_ v t N
Tenant:
t'"\0t\j G:.,� i�rk.r% Suite#:
Name: Y\ b\\ Nk (, .kk.41 Phone: tJ t 2.®,S1 81 3
Address / City / Zip: IC Li 3 i C� •-c x.,) c t': ('ye+. j(* i�
Name: (2, e 5 t 3._ •� t �. i `c� �c� � t A1cLicense #:
Address: is)c, Ft S - S City: 4e}‘ •r5
State: ("1.-N Zip: 5 5 01 Phone: 61 Z '7 2-4 - tSiri
Contact: Email: n4 \ A k 42. V\ 0.-k M GCM
New )( Replacement Additional Alteration Demolition tgrrx
ret,Pt a ce. -L... C.. ^cc..r Z`i 0,(3 3ct5 1 9'T0�
Description of work: 72...�te� .� � � ,, �. Cr I-11 S S A a%5 Aclo '1 Soco
RESIDENTIAL
Furnace
Air Conditioner
Air Exchanger
Heat Pump
Other
COMMERCIAL
New Construction Interior Improvement
Install Piping Processed
Gas Exterior HVAC Unit
Under/Above ground Tank ( Install / Remove)
RESIDENTIAL FEES
$60.00 Minimum Add or alteration to an existing unit (includes $5.00 State Surcharge)
$100.00 Residential New (includes $5.00 State Surcharge)
COMMERCIAL FEES
$55.00 Permit Fee Minimum
$70.00 Underground tank installation/removal
*If contract value is LESS than $10,010, Surcharge = $5.00
**If contract value is GREATER than $10,010, Surcharge = Contract Value x $0.0005
***If the project valuation is over $1 million, please call for Surcharge
d �
TOTAL FEE
Contract Value $ x .01
_$
=$
=$
Permit Fee
Surcharge*
TOTAL FEE
I hereby acknowledge that this information is complete and accurate; that the work will be i conformance wi
Eagan; that I understand this is not a permit, but only an application for a permit, and work is n o start witho
with the approved plan in the case of work which requires a review and approval of plans.
Applicant's Printed Name
x
he ordinances and codes of the City of
p rmit; that the work will be in accordance
Applicant's Signature