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3846 Country Creek Way12/09/2028 12:29 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5575 Fax: (651) 675 -5694 2011 RESIDENTIAL PLUM Date: "6– 11 Site Address: 3 Tenant: x Applicant's Printed Name #0203 P.001 /001 Applicant's Signature Use BLUE or BLACK Ink r... C re e 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.00pherstateonecall.orq I hereby acknowledge that ttris:infommatton 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 approvedplan in the case of work which requires a review and approval of plans. RESIDENT / OWNER Name: • fl Phone: (7 -CI " 3 `", Address / City / Zip: it- CONTRACTOR Name: v Cam. License #; 0 � `j �i ` f' p Address: ' Northam fa{ i'`q, ;;, City: • — 7401 Central Ave. State: Fridley; MN 55432 Phone: ' — "– 7A (� r Contact: Q•\'‘ C 'S K Es Email: Q. \ 't ` 1 e e.... t'j. 1, C•-•C TYPE OF WORK _ New Replacement Repair Rebuild Modify Space Work in R.O.W. _ _ Descrip of work: v _ EEX fl \ � PERMIT TYPE ES R I DENTIAL i � Water Softener ie rr / 1 � Water Heater tie- at k 4 -GT T Lawn irrigation L RPZ / PVB) Add Plumbing Fixtures L Main / _„ Lower Level) _,_ Water Turnaround 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 $55,00 Add Plumbing 'Water Turnaround $105.00 Septic System $95.00 Fire Repair (replace (includes $5.00 State Surcharge) Fixtures, Septic System Abandonment Water Turnaround* (includes $5,00 State Surcharge) (add $186.00 if a 5/8" meter is required) New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) TOTAL FEES $ 12/09/2028 12:29 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5575 Fax: (651) 675 -5694 2011 RESIDENTIAL PLUM Date: "6– 11 Site Address: 3 Tenant: x Applicant's Printed Name #0203 P.001 /001 Applicant's Signature Use BLUE or BLACK Ink r... C re e 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.00pherstateonecall.orq I hereby acknowledge that ttris:infommatton 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 approvedplan in the case of work which requires a review and approval of plans. PERMIT City of Eagan Permit Type:Building Permit Number:EA118310 Date Issued:10/30/2013 Permit Category:ePermit Site Address: 3846 Country Creek Way Lot:15 Block: 1 Addition: Cedar Grove 11th PID:10-16711-01-150 Use: Description: Sub Type:Reroof Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. Carbon monoxide detectors are required by law in ALL single family homes . Nathan Corbin Valuation: 4,000.00 Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 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 - John H Peterson 3846 Country Creek Way Eagan MN 55122 Corbin Exteriors LLC 1115 Southview Blvd South St Paul MN 55075 (651) 760-3116 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA167369 Date Issued:03/11/2021 Permit Category:ePermit Site Address: 3846 Country Creek Way Lot:15 Block: 1 Addition: Cedar Grove 11th PID:10-16711-01-150 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 - Johnny Roe 3846 Country Creek Way Eagan MN 55122 (925) 550-4469 One Hour Heating & Air 11825 Point Douglas Rd S Hastings MN 55033 (651) 437-4177 Applicant/Permitee: Signature Issued By: Signature