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4425 Clover Lane B úìú ÿþ þýý üûÿûú ùýýÿÿúéí ð ð þýö ýüûúùø÷ ñ ÷ ôö ÷ ñ üéü ý ôüòû óòôüòû ýÛ ý úù ãüùó÷ê ü ëþ ôðð òíà÷ýÞõ æêäêä õù ýü æêãêã ôó öòñ øø úùØ øø ñ ãüùó÷ ë ü ÿ ô àãßð ûùöÿë øø é ò ÿ òøùöøøûý é ýü ùé ÿì ê øøõ òýÿü üùýÿü CITY OF EAGAN WATER SERVICE PERMIT 3830 Pilot Knob Road P. 0.-Box 21199 PERMIT NO.: Eagan, MN 55121 DATE: Zoning: No. of Units: Owner: — — Address: Site Address: Plumber: Meter No.: Connection Charge: Size: Account Deposit: Reader No.: Permit Fee: 1 agree to comply with the City of Eagan Surcharge: Ordinances. Misc. Charges: ■ Total: By ` ♦ Date Paid: Date of Insp.: / ` Insp.: 5 2t 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: I agree to comply with the City of Eagan Connection Charge: Ordinances. Account Deposit: Permit Fee: Surcharge: By Misc. Charges: Date of Insp.• Total: Insp.• Dote Paid: PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA111502 Date Issued:06/26/2013 Permit Category:ePermit Site Address: 4425 Clover Lane B Lot:21 Block: 03 Addition: Eden PID:10-22750-03-210 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. Janel Behrends 122 West 3rd 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 - Patricia L Hanson 4425 Clover Lane B Eagan MN 55122 Haley Comfort Systems 122 West 3rd St Hastings MN 55033 (651) 437-0338 Applicant/Permitee: Signature Issued By: Signature From:ALLSTAR CONSTRUCTION 19529427464 09/1712013 08:37 #582 P.038/079 Use BLUE or BLACK Ink I For Office Use l n ' j Permit Clt~ of Eap I Permit Fee: ° 50 3830 Pilot Knob Road I I Eagan MN 55122 j Date Received. 1 j Phone: (651) 675-5675 I I Fax: (651) 675-5694 1 staff: I I I 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 01f5 l 2013 Site Address: y4Z3 442>g T 11 , 4L41CVR CIvex LAW/ Unit Name: dean VVr'1 CIO' C'JO yl cum Phone: Resident/ Owner Address /City/ Zip: W-1 J UiN "M Pftmi, Eym rare , M N 5 y Applicant is: Owner Contractor Description of work: My and yt Ybof Type of Work `l Construction Cost: 411 M''ll V U Multi-Family Building: (Yes / No Company: _t1 ILVIA t JjOtsLI VVI l l l ►Y`u ! Contact: .~-y Ct Contractor Address: ~Iy~ I~ndU CAI St 1e # city: Wit Nih State: Zip: ~1 Phone: License ~~,/r~ UI.~J~ S Icj Lead Certificate 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 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: 4 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 a a ~mvy~ conclude that thM 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.aopherstateonecall.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 6At S A x `L ° Applicant's Printed ame Ap li ant's Signature Page 1 of 3 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651) 675-5675 1 FAX: (651) 675-5694 buildinginspections(@citvofeagan.com -------------I r For Office Use I I Building Permit #: I I I SSW Permit #: I I I I Permit Fee: 22q 1 + I I I Date Received: I I I I I I Date Issued: I---------------------J RESIDENTIAL BUILDING PERMIT APPLICATION Date: hqlSite Address: Unit #: Applicant is: ❑ Owner Contractor Name: �G([ b V\- fie_ C) S 4455 C7 C? i 0-4 ; Address: qq2_3 Ah2 city: act a Homeowner ul� 5i! 2 ICU L� State: i Phone(:: Email: �'v� : P,e Q Description of work: t> e:,, Type of Construction Cost Li Work Type of building: ❑ Single Family ❑ Townhome, of units in Home Compan _.ThLI�M g IJljesk l� Building 'Address: � � �1 City: � Contractor `J '/ State:/ Zip: 5�3 T Phone6tZ�'f 5 Email lmel f \e" O'Z62(0 *� LCJD� ^- License #: Expiration Date: J Sewer & Company: Contact: Water Contractor Address: City: Required for State: Zip: Phone: Email: new construction License #: Ex iration Date: *1 understand that Plumbing, Mechanical, and Fire Suppression work require separate applications. 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. Contact Gopher State One Call at (651) 454-0002 or www.gopherstateonecall.org for protection against underground utility damage. Contact Gopher State One Call 48 hours before you intend to dig to receive locates of underground utilities. 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. Applicant's Printed Name A licant's Signature