1614 Clemson Dr BCity of Eagan
Eagan,
PERMIT
City of Eaan
Permit Type: Plumbing
Permit Number: EA099309
Date Issued: 05/31/2011
Permit Category: ePermit
Site Address: 1614 Clemson Dr B
Lot: 7 Block: 01 Addition: The Trails Of Thomas Lake
PID: 10-75865-01-070
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:
Roger R Miell
1614 Clemson Dr Unit B
Eagan MN 55122--481
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
Date:
Clly of Evan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK In
For Office Use
Permit #: /19D 113
Permit Fee: .06
Date Received:
Staff:
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
Site Address: %40I / eLE44sox) ezt, t Unit #:
/0'7/(3 II1
RESIDENT 1
OWNER
Name: Jai o 6e€R m /0-1Z-
1
,t1Z-
Address / City / Zip:
TYPE OF WORK
Phone: 6_0 sser6Bdp(D
J4 / `i a CL�.45-41j ss -
Applicant is; Owner Contractor
CONTRACTOR
Description of work: Z '4 C'-WSC E- 22a''
Construction Cost:., /100 a cro Multi -Family Building: (Yes %r / No
Company: TL.J/V di1Y 6-A. 9 Q„ Contact: J 1CVE .S%�f%/�y�R Z
Address: ✓5 ) ��E �� /t%
city: %%?
State: MN Zip: 5:5-1/07/6 a/8 Phone: q 5 -EA — 9'! `85-1:1�
License #:
L 30.15-0 eR... Lead Certificate #: Nf-7"- 7A. 3 73 --
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
eget- - NC> L -6,14/S
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 pian:
I Licensed Plumber: Phone:
Phone:
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
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 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 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.
Mechanical Contractor:
x SSE i/E S7-Aalovely604
Applicant's Printed Name Applicant's Signature
x
Page 1 of 3
CITY OF EAGAN WATER SERVICE PERMIT
3830 Pilot Knob Road
P.O. Bos: 21199 PERMIT NO
Eagan, MN 55121 DATE
Zoning* No. of Units*
Owner:
Address'
Site Addess•
Plumber E)£'"`
Meter No.: Connection Charge.
Size: Account Deposit'
Reader No • Permit Fee.
I agree to comply with the City of Eagan Surcharge.
Ordinances.
By
Date of Insp •
Misc. Charges.
Total.
Date Paid.
lnsp
CITY OF EAGAN SEWER SERVICE PERMIT
3830 P:.ot1Cnob 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 Date Paid:
C!ty of Baan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee: 3t1,
Date Received: 9 I Y I
Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Site Address: JO? /C72 1/ /1/4' �3 (ifCaisoj Unit #:
Date:
Name: Tritt /S o C Tho/v►-T 441/4
Address / City / Zip: 4)30vc
Applicant is: Owner Contractor
Phone: Oa 7117 7S a l
Description of work: fcerklee Psttl/1!tPDO{; Pjt`�C /A) 39 f ierei O 5jOivJ
Constructi_on_Cost:._
... d Mutt+- ana+4�r&uikJirrg. (Y� tt\to
_Tod. ries
Company: 8 ..SrL(l-44" 1 h cw'r
Address: 13qCity:
State: °IV •Zip' Phone: j,2 ---7
w 75.14
ticense # Lead Certificate #:
JVAr— 90
Contact:
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
A /•"r, CP<sPay I-,�� � yl d���
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:
Sewer & Water Contractor: Phone:
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.gooherstateonecall.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 of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota ;1 ate Building C • de must be completed within 180
days of permit issuance.
x �� �V f �`�- S
Applicant's Printed Name
x
Ap cant's Signature
Page 1 of 3