3572 Blue Jay Way Unit 1024101 CllyofEa
/ 2010 MECHANICAL PERMIT APPLICATIghl
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Date: 4 0 Site Address: 3 Z2 LYJ-� t i ve- / �'—
Tenant CJ sus. d:
PERMIT TYPE
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
Applicant rated Name
RESIDENTIAL FEES:
$50.50 Minimum Add-on or alterat on to an existing unit (includes $.50 State Surcharge)
$90.50 Fire repair (replace burned *A , ckxtva rtc, etc.) (includes $.50 State Surcharge)
COMMERCIAL FEES:
$70.50 Underground tank installation/removal
$50.50 Minimum (includes State Surcharge)
- If E is lea than $1.000, surcharge is 8.50.
- If E onli f is > 81,000. scrclarge W c eaaa each
by 8.50 Inc for ea
$1,000 Perm* Fee (Le. a $1,001- $2,000 Perm* Fee requires a 81.00 surcharge).
I hereby that Vt. infamalion is complete and accurate; that the work ws be in conformance
Eagan; that I understand this is not a pemn*, but only an * work
Inc for a pe, and is not
with the a proved plan kn the of work , a review and approval of plans.
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Perm* Fee: • ---''0
Dale Received:
Use BLUE or BLACK ink
OAWERCIAL
_ New Construction interior kr$xove ent
Install Piping _ Processed
Gas Exterior HVAC Unit
Under / Above ground Tank (_ Install 1 Remove)
When k staHinptrsmoving tangs). cad for Mspection by Fire
Marshal and Pksnbkhg Inspector
Tao TOTAL FE
OR Contract Value $ x 1%
the onbunces and codes of
t 8 the work ws be in
= 5 Permit Fee
=
$ Surcharge
=¢ 8 TOTAL FEE
CALL BEFORE YOU DIG. can Gopher st One call at (651) 464.0002 for protection against underfround ugly dera 5e. Can 48 hours
before you intend to dig to receive lops of underground utiMies. www.000hers tateonecall.or o
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