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
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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
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