3760 Burgundy DrRESIDENT / OWNER
Name: A-NA D, 12/.1e Phone:
A
Address / City /Zip: � ; i or ;, d•. ,:. TA_ / io
CONTRACTOR
Name /I I- Pr7:< 1 /L- �._ • /. Licenns�e� #:� e . 0J) —
�
A re §. C + a/ 3 * I-`f CityW %�
StateM 1 Zip: s 1 � '7 7 Phone: to cs j� --` /
Contact: 1 f c /b p/�J✓ Email:
TYPE OF WORK
_ New Replacement Repair _ Rebuild _ Modify Space Work in R.O.W.
_
Description of work:
PERMIT TYPE
RESIDENTIAL
Water Heater _Water Softener
Lawn Irrigation Add Plumbing Fixtures
( RPZ / PVB) ( Main _ Lower Level)
Septic System Water Turnaround
New
Abandonment
RESIDENTIAL FEES:
$50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge)
$30.50 Lawn Irrigation
$50.50 Add Plumbing
*Water Turnaround
$100.50 Septic System
$90.50 Fire Repair (replace
(includes $.50 State Surcharge)
Fixtures, Septic System Abandonment, Water Turnaround* (includes $.50 State Surcharge)
(add $166.00 if a 5/8" meter is required)
New ($10.00 per as built) (includes County fee and $.50 State Surcharge)
burned out appliances, ductwork, etc.) (includes $.50 State Surcharge)
TOTAL FEES $
City of Eagan
Tenant:
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
l
Applicant's Printed Nan'ie
x
Applicant's Signature
Permit #:
v
Permit Fee: Or ` C
Date Received:
Staff:
Use BLUE or BLACK Ink
2010 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: Site Address:
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.gooherstateonecall.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 e work will be in
accordance with the approved plan in the case of work which requires a review and approval o
x voi,d
Use BLUE or BLACK Ink
r _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
I For Office Use I
I I
Permit
City of EaMIR
Permit Fee: Cv' I
3830 Pilot Knob Road Ij I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675
Fax: (651) 675-5694 I Staff: j
I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: r~ 3 Site Address: ' --?74!0 v Unit
I Name: ge? '17 e-cC/ wal-tJ5 Phone:
i Resident/
Owner Address/ City/ Zip .96rg~aolv A,
Applicant is: Owner _X Contractor
Type of Work Description of work: -fear ep-a rerooO s'/cl-,7
Construction Cost: ` 40 Multi-Family Building: (Ye~ / No -QZ Company: ~s M / -,/In .e, Contact: g/// Xa-lc /
t
Contractor Address:vy,9l®d ~rnme.-- tS'~~E~ City: 9'!'1,JIS'
State:/)//7 Zip: -<I5 ~ Phone: 1fo7 9~609
License 9a2d q0 Lead Certificate 7 37~/~ 7
k If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
i
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
i
_Yes No If yes, date and address of master plan:
i
Licensed Plumber: Phone:
i
Mechanical Contractor: Phone:
i
Sewer & Water Contractor: Phone:
i NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
f 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. 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.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 State Building Code must be completed within 180
days of permit issuance.
x x
Applicant's P?inted Name Applican s Signature
of 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA124724
Date Issued:07/09/2014
Permit Category:ePermit
Site Address: 3760 Burgundy Dr
Lot:1 Block: 10 Addition: Seneca Hills
PID:10-67125-10-010
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.
Craig Angell
12253 Nicollet Ave. S.
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
Surcharge-Fixed $5.00 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 -
Ann Ditzler
3760 Burgundy Dr
Eagan MN 55122
Angell Aire
12253 Nicollet Ave S
Burnsville MN 55337
(952) 746-5200
Applicant/Permitee: Signature Issued By: Signature