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3612 St Francis Way Unit Ex 41 City of Eapli Tenant: 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 Date: 3 — ` Site Address: Applicant's Printed Name V' Sc 2 1tL 1VED MAR 0 9 2011 2011 RESIDENTIAL PLUMBING PERMIT APPLICATION ce *c r Q , 1 pplicanf = Signature Use BLUE or BLACK Ink riff Permit it / 4 / ' Permit Fee: 5' -e6 Date Received: Staff: • 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.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 permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval o ans. Reviewed By: _ Rough -in FOR OFFICE USE Required Insp Under Ground Air Test RESIDENT / OWNER Name: Q 1 i , c� K + S .e- r Phone: ce / 2 - - 7 u / - 3 5"73e Address / City / Zip: 3 .4- CONTRACTOR Name: i-4 t. s s o , PL, r... k r- s ter., vc..e_s tense #: 0 S 9 Si S r• , Address: / 0 - A a a - a 11 a City: ° -p' 1 State: AIWA Zip: SS / a ? Phone: to S I -- C. 9/- 8 Z S . . Contact: ; t( c 4 , 1 —._ Email: r Ir % , 1 c, r- b, v, , TYPE OF WORK _ New Replacement Repair Rebuild Modify Space Work in R.O.W. _ _ _ Description of work: RESIDENTIAL ter Heater Water Softener PERMIT TYPE Lawn Irrigation (_ RPZ / PVB) Add Plumbing Fixtures ( Main / _Lower Level) Water Tumaround Septic System New Abandonment RESIDENTIAL. FEES. $55.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) $35.00 Lawn Irrigation (includes $5.00 State Surcharge) Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge) (add $166.00 if a 5/8" meter is required) New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) 5.00 d Plumbing *Water Tumaround $105.00 Septic System $95.00 Fire Repair (replace bumed out appliances, ductwork, etc.) (includes $5.00 State Surcharge) TOTAL FEES $ SS- co x 41 City of Eapli Tenant: 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 Date: 3 — ` Site Address: Applicant's Printed Name V' Sc 2 1tL 1VED MAR 0 9 2011 2011 RESIDENTIAL PLUMBING PERMIT APPLICATION ce *c r Q , 1 pplicanf = Signature Use BLUE or BLACK Ink riff Permit it / 4 / ' Permit Fee: 5' -e6 Date Received: Staff: • 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.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 permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval o ans. Reviewed By: _ Rough -in FOR OFFICE USE Required Insp Under Ground Air Test Oct 2 2014 12. 05PM Crest Exteriors 651-463-8095 P. 5 Use BLUE or BLACK Ink �---------,-------� � For Office Use i J�7�10�- i Clty of Ea�a� , Permil#: I ' �7fi��� ' � Permll fes: � 3830 Pilot Knob Road j GZ � f j Eagan MN 66122 � Da1e Recelved: V � Phone;(661)676•5675 I Staff: � Fax;(661)676-5694 � � `__-_____ �._-____J 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Date:I� Site Address: ' Unit�I: Name:l� Phon��,�J���7�1� (1\��� ResiilenU P - . � � ��''�' Address/Ci p Owner h+/zt � ����,;,:_ ;,t•;.::,�,. : Applicant is: Owner Contractor ,:,�, R;-�•*�.�.;.�E,� �� ��R �a'�''�P`' Descrlption of work: - ' s e'of, o�� �'�.r..�� �l. /� "�-'' ' Canstruction Cosl:� v`� y Buildin :(Yes�1 No_� � Multi-Famil g :- ,. .. • Company:l J► �(�jl x�,( �1)1 J� LLJ� i _ContacL��,,� ,';�� �:: Address:�7 � I 1 � (\����Clty: . �;f3ontractor ��;,<--::�. (� �.,,`' • State:�Zip� lJ��'�' Phone: � `�mall:��,s1�T�.���r�� �Q,��2�r►�t License#:���\Y�7-�'�VJ���� Leed Ce�tificate#: If the project is exempt from lead certfflcatlon, please explain why: (see Page 3 for additional information) U �, �� 1 ;�� r� �� ' r, � � - ,i' 1� -� C� , COMPLETE THIS A A ONLY IF CONSTRUCTING A N�W BUILDING In the last 12 months,has the Clty of Eagan issued a permlt for a similar plan based on a master ptan9 ,�Yes _No If yes,date and address of master plan: Llcensed Plumber. Phone: Mechanfcal Contractor: Phone: Sewer&WaEer Contractor: Phone: NOTE:Plansandsu;���tl"� 'cu"`'e�� -Y�a�+q!/; ��i `�`r'e'cq P ')'E�'_o�lii.e' ubllcinfo►7ndtion. Port7onsof tfie informe'`�%n htay�°classif -i�y ��c' �. , ��would permi��Iie�City to .. _ . . ,- : . `_`Eo � e_ a��t r,a ts . .. � . ' CALL BEFORE YOU DIG. Call Gapher Stete Ona Call al(ebi)464•0002(o�protecllon againsl undefground ulility damage, Call 48 hours before you i�lend lo dlg to recelve locales of underground uIIllUes. www. o hersl e Il.or 1 hereby acknowledge thal lhis inforrnalion IS complete and accurale:lhal the work wlll be in con(ormance wlth lhe ordinanc�snd codes of lhe City of �agan;lhal I understand►hls Is not a permil, but only en appllcallon for a permil, end wollc fs not lo sleri wilhout a permll; Ihal lhe work v✓�II be in accordence wllh the approved plen(n lhe ease of work which requifes e fevlew and approval of plBnS. Ezterlor work authorizad hy a bullding permit issued In aeeordance wlth the Minne6ota Slale 8ullding Cada must 6a compleEed witnln 180 days of parmll Issuance. X ; �,W���.C�'�� � x . Applicant's P�Inted Name Applic nt's Slgnature Page 1 oF 3 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA167825 Date Issued:03/30/2021 Permit Category:ePermit Site Address: 3612 St Francis Way E Lot:010 Block: 05 Addition: St Francis Wood 4th PID:10-65903-05-010 Use: Description: Sub Type:Residential Work Type:Replace Description:Standard Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087 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 - Brian C Kaiser 3612 St Francis Way Unit E Eagan MN 55123--116 Homeworks Services Co Dba Homeworks Plumbing Htg 1230 Eagan Industrial Rd, Suite 117 Eagan MN 55121 (612) 400-9020 Applicant/Permitee: Signature Issued By: Signature