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4307 Clemson Dr BCity of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 4307 Clemson Cir B Lot: 15 Block: 02 Addition: The Trails Of Thomas Lake PID:10- 75865- 150 -02 Use: Description: Sub Type: e - Fumace Work Type: New Description: Furnace Comments: Fee Summary: Contractor: Ed's Heating and Air 1099 Pelto Path Woodbury MN 55129 (651) 775 -7490 Quesetions regarding elec 952- 445 -2840 Ed Pelto 1099 Pelto Path Total: Applicant/Permitee: Signature PERMIT City of Eaan Permit Type: Permit Number: Date Issued: Permit Category: cal permit requirements should be directed to Mark Anderson, State Elec ME - Permit Fee (Replacements) Surcharge -Fixed - Applicant - Owner: Jack F Hardin 4307 Clemson Cir B Eagan MN 55122 $50.00 0801.4088 $0.50 9001.2195 $50.50 Mechanical EA091536 10/08/2009 ePermit cal Inspector, 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 Issued By: Signature CITY OF EAGAN Permit No: Date: 3830 Pilot Knob Road Meter No: Size: P.O. Btx 21199 Reader No: Date: Eagan, MN 55121 Owner: Site Address: Plumber: Conn. Chg: Zoning: Acct. Dep. No. of Units: Permit Fee: Surcharge: I agree to comply with the City of Eagan Tr. Plant Ordinan -es. Meter: Misc.. By .L. l ir AK WATER SERVICE P 74 IT CITY OF EAGAN SEWER SERVICE PERMIT 3830 Pilot Knob Road P.O. Box 21199 PERMIT NO.: Eagan, MN 55121 DATE: Zoning: No. of Units: Owner: Address: Site Address: Plumber: I agree to comply with the City of Eagan Connection Charge: Ordinances. Account Deposit: Permit Fee: Surcharge: By Misc. Charges: Date of Insp.: Total: > Insp.: Date Paid: ;I I , Use BLUE or BLACK Ink For Office Use-__------ ' I ~1~44 I Permit City o aI 00 Permit Fee: i 3830 Pilot Knob Road 11( I Eagan MN 55122 I Date Received: t I Phone: (651) 675-5675 I 2 I Fax:,(651) 675-5694 1 Staff: I I _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ J 2013 RESIDENTIAL BUILDING PERMIT APPLICATION 13U 1 367/ 4 30q L 3018 e /l Date: 0 Site Address: ~ / (c/~,dN (e rUnit FName: ~ ~ 7 e) nnlts Phone: ?lF 7 7S12/ Resident/ Owner Address/ City / Zip: be !/y Applicant is: Owner Contractor t---.__ X n Type of Work ! Description of work: h. !t` e I S / _Construction_Cost: soa-- __------Mu+ti=Famifprrtlifiimg: (Ye/fro ) Company: 1 8 ~ 4r k .k#✓ h Joe fet I Contact: Contractor Address: City: State: V-V\V\ Zip:' Phone: : ~'f-7 I -Lfeenr : ead Certificate -i I f the project is exempt from lead certification, please explain why: (see Page 3 for additional information) FCOMPLETE 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: Plans and supporting documentsthat you submit are considered to be public information. Portions ofv 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.Qopherstateonecall.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 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 fate Building Code must be completed within 180 days; of permit issuance. -S x Applicant's Printed Name A I' ant's Signature Page 1 of 3