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