3426 Highlander DrRESIDENT /
OWNER
Name: A 11 ! —.A, 44114 "FJ A . IL!', :. 4 40 _ t i r.1 —119A- %2
Address / City / Zip: r a /1 ♦ 0 i fyyl�L
Applicant is: — Owner Contractor
TYPE OF WORK
i
Description of work: /. L A!. . Ji i . � A • .. /
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UQ / 1 t . it 1
Construction Cost J �' Multi- Family :wilding: (Yes ! No )
CONTRACTOR
_
Company:( Q J / /lL L/ Contact SA-111 V hay I N
Address:'T 1w C Zda4st -e B a::.. City: Car Luis p -LIK,
j // 3 h ".G _
State: r r (5
Zip: `t U1491 i, Phone:
I S
License #: /0 Lead Certificate #i: Ai / V s 4 -1
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
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
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: _
Phone:
_ Phone:
Phone:
more 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.
Jun. 8. 2011 2:43PM SELA ROOFING
Date;
'Thigri City oJiaau
Applicant's Printed Name
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
c+ ‘
Applicant's Signature
2011 RESIDENTIAL RI IILDIN(Z PERMIT APPLICATION
Permit It
No. 6530 P. 8
Use BLUE or BLACK Ink
C / 1 /6S
Permit Fee: /3 7y (9'
Date Received:
Staff:
J
l Site Address: ` .4. del • c.3`t - d
CALL BEFORE YOU DIG. Gall 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.nonherstateonecail.or t
t 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 wog 's not to st- , without a per pit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approv
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Page I of 3
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3830 Pilot Knob Road � ���J� � �
Eagan MN 55122 AUG 2 1 2014 � Date Received: t
Phone: (651)675-5675 � � �
Fax: (651)675-5694 �3Y:_�.. � �a��
L-----------------
2014 RESIDENtIAL PLUMBING PERMIT APPLICATION
Date:_4���!�� Site Address: r `-1 � `�`'\�. � ��
Tenant: ��\ ` Suite#:
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� ' � Name: (. Phone:��1`l � "l�l `��� �
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Address/City 1 Zip� � �
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� Name: L License#� �1`"l�� ��� �
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; Address: � t���,� � City: ,�L��,�_�� �
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� s State: l�J� Zip: l ` Phone�� ; > / ,C1�-�1�� �
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� Contact: � \�-�� ��Email: �. �
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� .� ����� _New �Replacement _Repair _Rebuild _Modify Space _Work in f2.O.W. �
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� Description of work: �� � ��� � �; �
` RES(DENTIAL �
� �
� Water Heater � ` t
� �awn frri atiort RPZ/ p�/8j � ` �ater Softener �
�li���"�1'��- 9 (— �
� Add Plumbing Foctures�Main 1_Lower Level)
� Septic System �
� New Water Turnaround �
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� ' � _Abandonment ���5�� �
� �,:�.,�-�.. ,- � ,���.� �.�_��,�- ,��,�<:.�
RESIDENTIAL FEES: £
�
$60.00 Water Heater, Water Softener, or Water Heater and Softener(includes�5.0o state Surcharge) }
� $60.06 ��wn i�t'igati�n�inciu��s$5.00 rr�ir.;rnur:�.ate S;:�char�e) r
�? $60.00 Add Plumbing Fixtures, Septic Svstem Abandonment,Water Tumaround*(includes$5.00 State Surcharge) �
*Water Turna�ound(add$200A0 if a 518"meter is required) �
� $115.00 SeqtiC SYStem New($10.00 per as built)(includes'County fee and$5.00 State Surcharge) al'� �
� � TOTAL FEES $ �� � �
�:�.�£-�.,,��.�.�,�.�, ����, �.,�,,��,,,�
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. wvvw.gopherstateonecall.ora
1 hereby acknowledge that this information is complete and accurate;that the work will be in conformar�e 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; tMat the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
X � `��r� ���hc���..._ X
Applicant's Printed Name Applic t's Signature
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PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA139589
Date Issued:10/31/2016
Permit Category:ePermit
Site Address: 3426 Highlander Dr
Lot:3 Block: 05 Addition: Surrey Heights 5th
PID:10-73004-05-030
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
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 -
Kuang M Rhoads
15 Red Fox Rd
St Paul MN 55127
(763) 218-6141
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature