1864 Casey Trt -
RESIDENT / OWNER
t �/! r� C)� 1 i
Name: f� t � l Phone: l"✓ l "1 C `i 1
j
Address / City / Zip: l� 1 ; 1 (.aAJX,
CONTRACTOR
.1•
Name: Appliance Connections lfCLicense #:
1313 Danita C. NN
Address: City:
Shakopee, M 55379
State: Zip:
952 -445
Contact: Email: ..
TYPE OF WORK
New 4 Replacement Repair Rebuild Modify Space Work in R.O.W.
— _ _
Description of work: _
RESIDENTIAL —
Water Heater ( Water Softener
PERMIT TYPE
Lawn Irrigation Add Plumbing Fixtures
(. RPZ / (_ Main Lower Level)
_PVB)
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." required) ,\ •
New ($10.00 per as built) (incljies County fee and $.50 State Surch' rge)
burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) i,r,
TOTAL FEES $ J V
4 City of Eaaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
.7 2010 RESIDENTIAL '
PLUMBING PERMIT APPLICATION
1 ` Site Address: I5(0 - 1 1. i'rcu `
Tenant: 1tti U 1 CAItI iS
Applicant's Printed'Name
I
AUG 041EC1
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 &underground utilities. www.aooherstateonecall.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 firs permit, and work not to start without a permit that the work will be in
accordance with the approved plan in the case of wdrk whirl requires a review and approvalp plans.
Appiic) it's Signature
Permit*: • Qnl'✓!
Permit Fee:
�o
Date Received: 1 ° f C
Staff: 131 L.
Suite #:
Use BLUE or BLACK Ink
FOR OFFICE USE Reviewed By: " Date:
Required Inspections: Under Ground _Rough-In _ Air Test _Gas Test _Final
Use BLUE or BLACK Ink
f I
For Office Use
Permit
± 1
City of Eap
Permit Fee:
313830 Pilot Knob Road I ~
Eagan MN 55122 I Date Received: 1
Phone: (651) 675-5675 I i
l
Fax: (651) 675-5694 i Staff:
1, l
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
✓~r
S
Date Ll Site Address: Unit #
'
Name Phone: ` 3P/
Resident! - - ,211 S V.
Owner e S'1 =<wj'~'
Address / City t Zip: ' -
Applicant is: Owner Contractor
Description of work:
17
}
Type of Work 3 Construction Cost:
Multi-Family E30tlcitny: (Yes /No
7 -S
V IV D ~ ` ,17"r~ 5 I'~ /fi r ifSlt✓ it ~r £ Contact: 136 i (r t,~ ~ 1. €
Company: ~fi
Address,2-10fl5~4 MAI 1 'f City: _'J
Contractor -
; 3 l g
u
State: 1 JS)- Zip t` - Phone:
License
Lead Certificate 7 ~ If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
f
t
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?
t
-Yes -No if yes, date and address of master plan:
I Licensed Plumber: Phone:
( Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone.
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 Gall at (651) 454-0002 for pr'o=[ ion against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities.
I herr;by vcknovwtedge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan: 0t4it 1 uncle mt;md 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
accc~r?ancc ~.vith the apf:uoved 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 Btjiidinq Code must Ise completed within 180 _w
days of permit issuance.
E
.--Applicant's Printed Name Applicants; Signature
Pa6,) 1 o 3
S
For Office U. se
City of EaPH I Permit A
I
I I
_ l
3830 Pilot Knob Road Permit Fee: ~
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 1 staff: 1
I 1
2008 REST ENT'IA UIL®ING PERMIT APPL ATION-^-----
Date: r ! `7' Site Address: fzL`~ _ J o /glc /Z
4
Tenant:
Suite:
RESIDENT" / OWNER Name: Phone:
Address / City / Zip:
Applicant is: Owner Contractor
TYPE OF WORK Description of work: _ T} xeo 7a
Construction Cost:
i Multi-Family Building: (Yes- / No
CONTRACTOR Name: A ~I ~-5' ~'~Jr7 14 7-5~tr7Ce' License
Address: 7 GtYf'7 Z~'!' > r~ ? -Q 1
State: IV41 Zip: , ~-J I13
43
Phone: 82 Contact Person: > >
COMPLETE THIS AREA ONLY IF CONSTRUCTING NEW BUILDING
` Minnesota Rules 7670 Category 1 Minnesota Rules 7672
Energy Code Residential Ventilation Category 1 Worksheet New Energy Code Worksheet
Category Submitted Submitted
N submission type) Energy Envelope Calculations Submitted
In the last 12 months, has the City or 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:
NOTE: Plans and supposing documents that you subm are considered to be 'public inforrr~afion Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that the are. trade .secrets.
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 {
agan; 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
ccordance with the approved plan in the case of work which requires a review and approval of p ns.
.pplicant's Printed Name Applicant's Signature
Pagel of 3
i
Ii
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA146387
Date Issued:10/23/2017
Permit Category:ePermit
Site Address: 1864 Casey Tr
Lot:112 Block: 02 Addition: Cliff Lake Townhomes 2nd
PID:10-17791-02-112
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
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 -
Mary J Kacvinsky
1864 Casey Tr
Eagan MN 55122
(952) 594-9891
Standard Heating & Air Conditioning
130 Plymouth Ave. N
Minneapolis MN 55411
(612) 824-2656
Applicant/Permitee: Signature Issued By: Signature
For Office Use
� r
Permit#: / '7
EAGAN REC1 Permit Fee:
��N y A � ) Date Received: f -
3830 PILOT KNOB ROAD EAGAN, MN 55122-1810 Jl V
(651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff:
buildinginspections(a�cityofeauan.com L
i 2018 RESIDENTIAL
l PLUMBING PERMIT APPLICATION
Date: 1 ?\ Site Address: Ifs f --I _c.S e\,j cci
Tenant: ( ') ,Suite#:
Resident/Owner Name: V\CA V(i3 J .C V I f S�� (�/
Phone: `�l`�2-�,G'I
Address/City/Zip: `1,11' ci h I" I N
Name: Wn ZO f License#: U Ll?
Contractor Address: 22/O U _ 1\N I /J _City: 6u(111CVSAU.
State: \-)\ Zip: CG'. Phone: — 1(Vf
Contact: Email: �(� (/ C I l.i �2/ a f ,c6-77-2
Type of Work New L Replacement Repair Rebuild Modify Space _Work in R.O.W.
Description of work:
RESIDENTIAL
rWater Heater
Water Softener
Lawn Irrigation( RPZ/_PVB)
Permit Type. Add Plumbing Fixtures(_Main/_Lower Level)
Septic System
New Water Turnaround
Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater,Water Softener, or Water Heater and Softener(includes State Surcharge)
$60.00 Lawn Irrigation (includes State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment,Water Turnaround*(includes State Surcharge)
*Water Turnaround(add$280.00 if a 3/4"meter is required)
$115.00 Septic System New(includes County fee and State Surcharge) TOTAL FEES $ (o D. 0 1..'
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
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.citvofeagan.com/subscribe.
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 fora 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.
x x
Applicant's Printed Name Applicant's Signature
FOR OFFICE USE Reviewed By: Date:.
Required Inspections: < Under Ground Rough-In Air Test Gas Test Final
Meter Related Items: Meter Size Radio Read Manometer Staff: '