4313 Clemson Cir B
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CITY OF EAGAN Permit No: Date:
3830 Pilot Knob Road Meter No: Size:
P.O. Rox 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 Ordinances.
Meter:
Misc By �
WATER SERVICE PERMIT 7 -
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:
agree to comply with the City of Eagan Connection Charge: ry 5 " n .4
Ordinances. Account Deposit:
Permit Fee:
Surcharge:
By Misc. Charges:
Date of Insp.: Total:
Insp.: _ Date Paid:
C!ty af Eaaali
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use h
Permit #: d _ 3�
TTTT
Permit Fee:
Date Received: ///�� / V -)111"""
Staff:
2012 MECHANICAL rPERMIT APPLICATION
Date: Site Address: L3 ..? @t UM 5 al 0.-:(
Tenant: Ocha to
RESIDENT / OWNER
TYPE OF WORK!
Suite #:
� I
Name: WO/1 e,e Phone: 6175-3) LI (M)
Address / City / Zip: LI �� C 1 CI k5(5Y .
Name: -Appliance -Connections -Inc,
License #: 7Zoc'1 PM
Address: 12850 Chestnut Blvd. City:
Shakopee, MN 55379
State: 952-445-4803 Phone:
Contact: Tt:WI& 12-E � Email:ci_pf1Ia. VIu. C.Oi'tVIGG(1rns .Q 4_d.Lta:).(,oYY1a.
_--
____ New Replacement Additional Alteration
Description of work:
NOTE:
Code
d and
ritact tht
RESIDENTIAL
Furnace
Air Conditioner
__ Air Exchanger
Heat Pump
Other
NAck-cial_ _r
d mounted r __
lechanical Inspector f
Demolition
COMMERCIAL
__ New Construction ___ Interior Improvement
Install Piping Processed
Gas Exterior HVAC Unit
Under / Above ground Tank (___ Install / __ Remove)
RESIDENTIAL FEES:
$60.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge)
$100.00 Fire repair (replace bumed out appliances, ductwork, etc.) (includes $5.00 State Surcharge)
TOTAL FEE
COMMERCIAL FEES:
$75.00 Underground tank installation/removal (includes $5.00 State Surcharge) OR Contract Value $ _ x 1%
$60.00 Minimum (includes State Surcharge) = $ Permit Fee
- If the Permit Fee is less than $10,010, surcharge is $ 5.00 =
- If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee $ Surcharge
(i.e. a $10,010-$11,010 Permit Fee requires a $ 5.50 surcharge) = $ TOTAL FEE
CALL BEFORE YOU DIG. Call Gopher State One CaII at (651) 454-0002 for protection against underground utility damage. CaII 48 hours before
you intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq
1 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.
Applicant's Printed Name
x
Applicant's $ridnature
FOR OFFICE USE
Required Inspections:
Underground
11,1
Gity of Eaau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #: _ __)6
Permit Fee:
Date Received:
Staff:
2012 RESIDENTIAL PLUMBING PERMIT AP LICATION
Date: t 1 Site Address: q/,3 Cieien5oiii
Tenant:
RESIDENT / OWNER
RESIDENTIAL FE
$60.00 Minimu - - . -r, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$60.00 Lawn Irrig. • includes $5.00 State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment Water Turnaround* (includes $5.00 State Surcharge)
*Water Turnaround (add $189.00 if a 5/8" meter is required)
$105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)/ ,
TOTAL FEES $l(/.0v
1
Address / City / Zip: ____________
Suite #:
Phone: �� " /✓ � 9y
Name: n p�Gonnees-e7-- License #: CLS122fT
Address: 12850 Chestnut Blvd. City:
87StaShakopee, MN 5-5370-
State:
te: Zip: _54 _ Phone:
Contact] _kt)
Email: _______ _
___ New replacement ___ Repair ___ Rebuild, Modify Space ___ Work in R.O.W.
Description of work:
RESIDENTIAL
_ Water Heater
___ Lawn Irrigation (___ RPZ / PVB)
____ Septic System
New
___ Abandonment
____ Water Softener
Add Plumbing Fixtures (__ Main / ___ Lower Level)
Water Turnaround
CALL BEFORE YOU DIG. Call Gopher State One CaII 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.gopherstateonecali.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 permjthat the work will be in
acco ance with the appr ed plan in the case of work which requires a review and appr •1..1 of plans.
1�
Applicant's Printed ampPI
x
A ant's Signature
FOR OFFICE USE
Required Inspections:
Under Ground
Reviewed By:
Rough -In Air Test
Date:
Gas Test
Final
Use BLUE or BLACK Ink
For Office Use
04
Permit 1L
I 0 oe~ 1
C*ty of Ea
Permit Fee:
38,30 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 1 n
Fax: (651) 675-5694 1 Staff:) I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: ~ 3 1 13j) o ji3 j -3 x}3,3)3 C 1 em so, - O_1'~ Unit
F~ -_i Name: -24Tr l 5 0 ,•1 A 0,14-A-5z L~4 1•~~L1)eh Phone: '!~4o2 7 7
Resident/
Owner ' Address/City/Zip:
{ UJQ
W Applicant is: Owner Contractor
i Description of work:/aka tkp~~ gk Ae' w
Type of Work 7
V li' C....,..
_Constructi4n..Cost:_ IVD
TLS -,5~aCrllilc ~h C. • o v
I Company: Contact:
Contractor Address: City:
6 f 2- 7 -
I State: •Zip: 552i (a Phone:
titertse # - Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
'r ~ 9 A
0 fold V'_1
I 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:
i NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
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.aooherstateonecall.org
1 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 l 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 Minneso State Building Code must be completed within 180
days of permit; issuance.
X_ x
Applicant's Printed Name rant's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA141920
Date Issued:04/06/2017
Permit Category:ePermit
Site Address: 4313 Clemson Cir B
Lot:10 Block: 02 Addition: The Trails Of Thomas Lake
PID:10-75865-02-100
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 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 -
Jeanne M Wendel
4313 Clemson Cir B
Eagan MN 55122
(651) 303-6455
Centerpoint Energy
1240 W River Pkwy
Minneapolis MN 55454
(612) 321-5597
Applicant/Permitee: Signature Issued By: Signature