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1265 Timbershore LaneCity of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 1265 Timbershore Lane Lot: 3 Block: 03 Addition: Timbershore 3rd PID:10- 76502- 030 -03 Use: Description: Sub Type: e - Furnace & Air Conditioner Work Type: New Description: Fumace & Air Conditioner Comments: Quesetions regarding electrical permit requirements should be directed to Mark Anderson, State Electrical Inspector, (952) 445 -2840 Fee Summary: Contractor: Home Energy Center 2415 Annapolis Lane #170 Plymouth MN 55441 (651) 766 -6763 ME - Permit Fee (Replacements) Surcharge -Fixed Total: Applicant/Permitee: Signature PERMIT City of Eaan - Applicant - Owner: G Dean Goebel 1265 Timbershore Lane Eagan MN 55122 Permit Type: Permit Number: Date Issued: Permit Category: $50.00 0801.4088 $0.50 9001.2195 $50.50 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 Mechanical EA091571 10/13/2009 ePermit '1\7E13 For Office Use hi f �3� f f. Permit If: ` ` a< OCT 15 2019 ��/j Permit Fee: ` 3-- Date Received: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (65 1)675-5675(TDD: (651)454-8535 I FAX:(651)675-5694 Staff: buildinginspections ca cityofeaoan.com 2019 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit#: Name: ,m l Ucvr7 0 rat e-S Phone: 95,Z—a 3 9— 900 2., Resident/ k Owner Address/City/Zip: / 2 6 3 ! 'm r'i-1'4 / e Applicant is: Owner Contractor Type of Work Description of work: (J c-.) S7,'S Construction Cost: Multi-Family Building:(Yes /No ) Company: 6 cis fe Contact: V w^e, #0,'e ca, / y� Contractor Address: /& 3 �, /y/Cin Cit C/ /Ctxf City: _../3fuuyr p-75 7V State:/ `4'.Zip: cc'/3 c hone: )�.7)742 3 9— :c2,,. C. • rP7 w License#: Lead Certificate#: If the project is exempt from lead certification, please explain why: 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: Fire Suppression Contractor: Phone: NOTE:Plans and supporting documents that you submit are considered tole public Information. Portions of the information maybe classified as non-public if you provide specific reasons that would permit the.011y to conclude that the are trade secrets. You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeanan.comisubscribe. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. 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. wvw.gopherstateonecalt 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 approval of p ns. Applicant's Printed Name J Applicant's SS ature DO NOT WRITE BELOW THIS LINE La ol- -C- ,—k-Dt(c r� (Jr..( 1 If-sp .SUB TYPES C _ Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family) Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration(Multi) Multi _ Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous 01 of_Plex _ Lower Level — Pool _ Accessory Building WORK TYPES New _ Interior Improvement _ Siding _ Demolish Building* Addition — Move Building _ Reroof _ Demolish Interior I — Alteration — Fire Repair _ Windows _ Demolish Foundation 1 Replace _ Repair _ Egress Window _ Water Damage Retaining Wall *Demolition of entire building—give PCA handout to applicant — DESCRIPTION Valuation 2tialq Occupancy ML, MCES System Plan ReviewCode Edition SAC Units (25%_ 100% X) Zoning City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction W Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final/C.O. Required Footings (Addition) Y Final/No C.O. Required Foundation Foundation Before Backfill 1` HVAC_Service Test Gas Line Air Test_Hood Roof:_Ice &Water _Final Pool:_Footings Air/Gas Tests _Final Framing 30 Minutes 1 Hour Drain Tile Fireplace:_Rough In Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick_EFIS Insulation Windows Sheathing Retaining Wall:_Footings_Backfill_Final Sheetrock Radon Control Fire Walls Fire Suppression:_Rough In_Final Braced Walls Erosion Control Shower Pan Other: Reviewed By: , Building Inspector RESIDENTIAL FEES } �p � Base Fee ' aue,„ frunir Surcharge c-r-gls Plan Review 01 f MCES SAC City SAC04 Utility Connection Charge S&W Permit&Surcharge Treatment Plant91 0 t 0 Radio Meter Read Copies TOTAL Page 2 of 3 I'1