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1898 Southpointe TerRESIDENT / OWNER ' 65"/ - 1-1 S��- S3 n y- 1 Name: GI( 4 (F , Phone: ' - _ - - (�{}- y c Address / City / Zip: p 975 6' ©U 4- o ` P `pie L° Y P r p UCt � ` �(, �-C CONTRACTOR Name: Pe F OR 4e 4 ePA,Ck zt-pJr c`crr ci� g nse #: Address: / C 5 0 P e h -- b f l e � d©c9 { .. iitty: Prep (R', �q k e State: 1,t& fr . Zip: 53 3 / ,:, Phone: 9 54 [ IN 7— 871 0 Contact: t i)ed't ' A - d"e hS-C- , Email: TYPE OF WORK New Replacement Additional Alteration Demolition Description Description of work: R mue. 4- Re \ace r 'n-./Nc-e 4- �- R- Co r te} 4, f. NO Roof m ount ed and ground mounted mechani equip ment is required t be screene by City, Cod Please conta the M e chanical Inspector f info p ermitted screen tne o ds PERMIT TYPE RESIDENTIAL ‘F. Furnace COMMERCIAL New Construction Interior Improvement ( Air Conditioner Install Piping Processed / Air Exchanger Gas Exterior HVAC Unit Heat Pump Under / Above ground Tank (_ Install / Remove) Other ** When installing /removing tank(s), call for inspection by Fire Marshal and Plumbing Inspector RESIDENTIAL FEES: $50.50 Minimum Add - or alteration to an existing unit (includes burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) $.50 State Surcharge) $ TOTAL FEE $90.50 Fire repair (replace COMMERCIAL FEES: $70.50 Underground tank $50.50 Minimum (includes installation /removal OR State Surcharge) surcharge is $.50. increases by $.50 for each - $2,000 Permit Fee requires a $1.00 surcharge). Contract Value $ x 1% = $ Permit Fee - If Permit Fee is less than $1,000, = $ Surcharge - If Permit Fee is > $1,000, surcharge $1,000 Permit Fee (i.e. a $1,001 = $ TOTAL FEE 40 City of Eaaail 2010 MECHANICAL PERMIT APPLICATION Date: 4 � /f O Site Address: 13 9 ' ��u y' �t po et - e . e ey — c e { Suite #: Tenant: / a-r }F Kay bit 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 wit the approved plan in the case of work which requires a review and approval of plans. x e a. A( e(") -� F 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 Applicant's Printed Name Applicant's Signature r Use BLUE or BLACK Ink Permit #: 624(;2 ` Permit Fee: - e �3 O Date Received: tJ Staff: goonalta R OFFICE ,� eenrn ,., ......... ... s ' ...„ , , 548,-.:`:,;',,-, ,.e, ?. /'. ,..... ,.z.,-*;:',1',..:.';'3,:. ',..,•.'''''.."1',S, ' -.":- ''','' ' ..' '''''';:i. , .''...:"‘: ''.! 4,846, ' ''' •:./till ' :-.--::,...-. 1;;,,..•:'!'!.3041,146tifi''''''',.-.,--'.-t';:...‘-- '-'-.''''''':.':',--,,-'-'',:,.-.(;;?:',..:; ',..„-:'."..,I, 1..t.*- ---..:::.,..-..i,...,,,,,-2:. .i:.,---:,..:.- ..,....::77.-----:-.....i...,,,:j-;',!:::4 -?-..,•2.,-,,,--,..:,,,ii1-4.--,-:,-1---'•-:-,.;-,,...1%to - ' r - ' .'' ' .. I'''-''''''''7.. ' '''': ' ' '''.:■ '....;'''': :'41416ffialle.'''''' '''''' .r:''' ' T':' ''''' '' (:S;: .;:'...'''''4'''''''''' :' '*'' '''''''.1:;.'fi' :,...1:440 . ' . /, . • ':: ' ' , , , :,,,,,:,. - '''. ' ''::'' ' ..: . ,., . '4 7 7.777.e.,. 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';'r ' 'i . ,.,•74-,..,7,,,,,,,,, ,- ..c ., ;, ,,, .. , : , t„ - „ , „: , -: : ::;,- , ::-:. :.,',..,-,.:.-; -:;:' -:: ,,,,: :,..,,,,,,,I,..7,,,,--2,-..i- --..'...... - ; ; ; 7, 7 .. ...,-. , ...,,,,-,-..„,),....-..,,, :.,,,,,,-- ir 4 36 .. ; .: ,._ , .,„..,.:,-..-..,,,,,,-_-;:;,,,...,,:;::::„;.. -,,,„....-.1i,:4,..,,Jc,,,,:.:g., ',,:---; „, Ii.i''::2.:,-;'1, Zli rs,140 j 7 �y . :,, ... tare T r femm hi a y. j � U�e BLUE or BLACK Ink �-----_..�_-------i . � For OlMce Use � ; Pw,,,it� Z�'S/Z� I �� 0��� � Permit Fee: I J,� I 9830 Pibt Knob Road j I Eagan MIN 661ZT � Date Reoeivad: i Phons:(651j 695�678 � � � Fax:(661j 675�684 � � �._____________�__� 2013 RESIDE�TIAL BUILD�NG PERMIT APPLICATION i�7s�� s��. 8x,�r�i; s�� St� s- -J�/ ' cu� o,.J rd ,�'2 Date: Sibe Addro�s:/�� 9 A,�'/�4 6,9 B,i� S�ouTii�P UnR�: � �,. , Name:GLc f1 G 7" /y1�4,J+4���'N SU: .�"�C Phone:7(r� -S'S3 - 4770 Raa� .� Gr►e��,..D 1�r�c.�' Oy�e� , Address/Ciry I Zip: �'S�D � �G�l rv.Q Ad p � ; �- '..: �,�,�.0 s'Sy�7 � �. Applic�nt is: Owner ,�Contredor ��,���. �escription of wortc: `T s,g,2 oF-f" � 2� �F � � , ConsUvction Cost��x 7 85.GQ Multi-Famfly Building:(Yes � /No_� . >t� ��1 .' company:G,�E J �'ar r�,¢�o.¢ /y17i..�:. �p ContacC ��v�� ��r�R�5 ��r, Address: �o S' � 6 0� S�. �;�: /h P�s ' � - � State: /Yl�Zip: SS'// 9 Phone: �O'z �b�' �Z`/3 � � , Licorts�#: �C .�y 1I 3/ l.ead CerWicaLe#: ff the projeGt is exempt from lead certification, ple�ase explain why: (see Page 3 for addiGcnal information) ����s t,J�2� R��-�r. Pos; J 97 S' COMP��T'E THIS AREA ONLY IF CONSTRUC71NG A�i„IEW BUILDING In the last 12 manfhs,has the city of�apan lesued a permn'br a sirnilar plan baasd on a ma�bBr plan� _Yes ,.,�,No If yes,date anp�ddress of ine�ter plen: liceneed plumber. Phone• MecAanical ConWttor: Phone: Sewer�Wa�er ContrA�tor. p��; ���,'��. , ,o .. ; .. �,� � � . .�g, _ �p r,�jjr' •��y 'G •S7+c•'�l' '�`� ��� .`x,�;`,i',` :'I'��::'�a��aS �'�",� rY���!' �,p ;'.��F��j���'yl'. CA„LL B�FORE YOU DIC3. C�II Gppher Sbq One Cal)at(B61)46L-0002 for protedion ageiytigt unde(ground udlily damage. CaU d$hpuls befnna yau it�end to dlg to rec�lve locete4 af undarground utqftles. y�!,9pphersr�teonecad.o� 1 heroby ackrwwledge that this informadon is ramplate and axurate:Ihar the work will be in coriformance wdth d�e adineuioes end oodas af Ihe City of EaBan; that I undelStend itqs is rlot�permk.but on}y an eppiication fnr 8 OermR.and work fa noC to stert without a oam+lt;that the�wnc win wo in s�wd.nw w:u,eno oPWvwd pen m tno osee dwv(k vMnldl roqW�S d rEVioW anC 8ptlfGV8101 p{0►Ie. F.xOerior worlc authprized by d buildin8 pertnit(saued in�dance wF!!�tfle Mlnnesota StaEa Bulldi Cqda mu�st bs Completed within 180 days of penni�ieouance. X I��..�A �a212 �S ApPlicanP's Printsd Nams x _ App11canCe Signatun vega��s Z0/Z0 �9vd 1NIvW 1X3 I�g L9Z9Z98ZZ9 bS�80 bt9�/TZ/99 Use BLUE or BLACK Ink � ������������� i � For ORice Uae. � � I • ; pe�►n�: � � 1 i C�t of�a � � � � � � '"��;' �'i� !�"°*'°.� ; Pertnit Fee: � 3830 Pilot Knob Road Eagan MN 55122 /' � Dabe Received: i Phone:(651)675�,675 � 1 Fax:(651)675-5694 � �' j V���������������_J 2013 RESIDENTIAL BUILDING PERMIT APPLICATION �-�� l� >�78, �Pd,sz, gy, ��, S3� o�.�:� TL2< Date: Site Address:���e►,,px, Fy,q�,y�,r Sc,� SovrflP Unit#: � Name:��o A C T /y1�4 n.3�4�E/'tit E�T .T•}C Phone:7l03 -s'9 3 - �7�o Res�e�i#/. , . � ��� . : , Adaress�city r zip: �so � �e.�4 7—,�,2 Av ,c� '� �2 1'9 �oi�E.•' f/r}�L.L�£� • /r�•�s s',T"y',t 7 � Applicant is: Owner �Contractor ' :''�� •..�. Description of work: /1�K o ci E � (2 ���F�� ��d r s�S�o TYPe;��YoMc Consbvction Cost�•�� �� — Multi-Family Building:(Yes � /No_� ' Company: �£ I £��r f2�o R Iy1�t'i..��. �� Contact ��v�� Q�'R-R�5 ��;4 -. .: '. : Aadress: �i/os t� bv� S�. c;ty; �PL S. Coa�ai:�cr��`�. _. - • State: /Y�� Zp: S'$�y/ 9 Phone: !o�,'� - �6�� �Z�/3 � . License#: �C .�y�/3/ Lead Certificate#: � If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) I�.iLDloS t��2� �vlL� POS; ! S� 7 � COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 mo�,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 ptan: Licensed Plumber• Phone• Mechanical CoMractor: Phone: Sewer�Water Contractor: Phons: !��j 1�I0!/S���R��.M...' .��`Fr. r+7`�..�}t' `: '✓.'. .'.�.� , a,; .. t�. � +�. �, ,c. •,�-,y:fS VlC,7�� � � � � Y +. Yr � ��?gS� ,�,1�. ',��. ,`'�_.,�.�y..,,�. + ��1 & , ,�,�� �b::`; :w ,:`, �,,.. .1.. ,���,w�,a��!{.::..,���/ s �t .i��:.;.• �5� Yj�?��W+�O�y'#'W,J :.y�J{d"•.'.•.. i.w'^'.y'.�� td� st .d CA�I.BEFORE YOU DIG. Call Gopher Stabe One Cal!at(6S1)454-0002 for prote�ction agair�st underground otility damage. CaII 48 hours before you ir�tend to dig to nec:eive locates of underground utili6es. wuvw.ao�heistateonecall.or4 I hereby adcnowledge that tlus informaUon is oomplete and accurate;that the woric will be in confortnanc�e with tl�e ordinances and codes of U�e City of Eagan; that I understand this is not a permit,but only an application for a pertnit.and woric is not to start without a pertnit;that the w�k wiu be in acoondance wkh the aPP��1 Wan in the caSe 01 Wpltc vyhlUl fgyUifCS 8 fCViBNV 8fld 8�f'OV81 Of�113(18. Ezbena'work suthoraed by a building permit issued in accordance with ttw Minne.sota S�ts Buildi Code must be completed within 180 ��Pe�lt Issuance. x ��Avi� ��22rs x Applicant"s Prirrted Name APplicant's Signature Page 1 of 3