1525 Greenwood Ct NCity of Eagan
Eagan,
PERMIT
City of Eaan
Permit Type: Plumbing
Permit Number: EA097770
Date Issued: 01/18/2011
Permit Category: ePermit
Site Address: 1525 Greenwood Ct N
Lot: 6 Block: 04 Addition: Surrey Heights 1st
PID: 10-73000-060-04
Use:
Description:
Sub Type: e - Water Heater
Work Type: New
Description: Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:
Kris Oien
3670 Dodd Rd
Eagan, mn 55123
651-365-1340
Fee Summary:
PL - Permit Fee (WS &/or WH) $50.00
Surcharge -Fixed $5.00
0801.4087
9001.2195
Total: $55.00
Contractor:
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
- Applicant -
Owner:
Kathrine M Zeimet
1525 Greenwood Ct N
Eagan MN 55122
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.
Applicant/Permitee: Signature
Issued By: Signature
Aug. 1. 2012 12:37PM Sela Accounting No. 1661 P. 13
Date:
City of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone; (651) 675-5675
Fax: (651) 676-5694
Use BLUE or BLACK Ink
For Office Use
Permit*:
r+7
Permit Fee:
bate Received:
Staff:
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
8/1 /12—
Site Address: 152-30525,1SZ7,1 9 Greenwood C&h- ( unit#:
RESIDENT/
OWNER
Name: ivmrt'�/ VA- rq�'-s T[a,i�hu' ► a2Lc)c Phone: r•�5.-?3I-Ia33
/ J � 1 . � 1�-!2,G\c� r -
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Address / City /Zip: ((MS' a\ --hi (�PSf c-11,-- KJ- , V
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Applicant is: Owner X( Contractor
TYPE OF WORK
Description of work; Fe'ebb C�--
Construction Cost 1? D9,S • UU Multi -Family Building: (Yes / No _)
CONTRACTOR
Company: S eAck,^ (.bo (�ni 4- &Vilr- d e.)1 Al► Contact Kqr r j
Address: L((CU F".XCt,A Sl oto g\ v 1 J City_ St (L Ata Po r- k_
State: on 1(- Zip: S 5'-I 1 `v Phone: Cj 6 d..-cl 1 5 -- -7 v -c . L.
License #: C 12 C>C01 0 50 Lead Certificate #: AfA 1 — a 5 (33 11 `"
If the project is exempt from lead certification, please explain why: (see Page 3 for additional Information)
In the last 12 months,
Yes No If
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan Issued a permit for a similar plan based on a master plan?
yes, date and address of master plan;
Licensed Plumber: Phone:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
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 Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you Intend to dig Io recelve locates of underground ulllitles. www.gooheratateonecall.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 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 (he 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.
-Nur k Yl Ga r -A1 -N r tAA,vt,
Applicant's Printed Name
Applicant's Signature
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