3441 Highlander DrRESIDENT /
OWNER
Name: LL!.J ad/ ., 1 - 7; 1I. L 'i d - / Phone: A ga 5t.
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Address / City / Zip: 00 o� . ,
1
Applicant is: _ Owner Contractor
TYPE OF WORK
1
Description of work: " L* . �. /. A. •
IF f
Construction Cost: l 1 O di • - Multi- Family Building: (Yes I No J
CONTRACTOR
Company: A €.6qc 1146r Contact: 4 ;/l)Vlt. f i i
Address: �OO EME L i LV 0 V Cit - L41,61 P!' " .-1� -.-'
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State:! 1-li I Zip: / t 5' i Phone;
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License #: IOW OW Lead Certificate # [ : 9 td� � 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
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:
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
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_therare trade secrets.
Jun. 8. 2011 2:45PM SELA ROOFING
City of Eap,all
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
€'fir VAN LC /0,5
Applicant's Printed Name
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
Sate: 744
icant's Signature
Eiji :PAW
cW
Permit 0; 6 9q6
Permit Fee: t
Date Received:
Staff:
No. 6530 P. 17
Use BLUE or BLACK Ink
J
Site Address: SAS? 1 4 ' C r 6 x1 Unit 3J `-' g
CALL BEFORE YOU D1G, 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.oro
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 out a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval • - ns.
Page 1 of 3
E ARN WATER }SERYIGE PERMIT l' ''
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: ? 10 t< .K� road ' - ATc NO #
r o ( N3 5 r 32 DATA *,
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a Meter No Connectio Charg f " r
, Size Acc ount De it
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g pty with the C of , Eogo n :Surcharg ` " "' _"
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Ordina misc. Charges: -- -
:Total:
By - / Date " Paid
Date of I nsp & / � I nsp.:
IT
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1 ag com ply with t he City of Eagan _ orine Ch "
- Ordinances Accoa t ®,
il
Pe Fee:� s
_ � S Ur cFiarge: .- -- s r
r .. .. ,A•• =- Misc. Charges . 9
Date o ln sp , To tot
rl nsp •- --r�- - * "- . .w Date Paid: 1
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA159274
Date Issued:12/05/2019
Permit Category:ePermit
Site Address: 3441 Highlander Dr
Lot:1 Block: 04 Addition: Surrey Heights 6th
PID:10-73005-04-010
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Standard Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
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 -
Erin M Metoxen
3441 Highlander Dr
Eagan MN 55122
Adam's On Time Plumbing & Water Heaters Llc
13791 Jonquil Lane N
Dayton MN 55327
(612) 205-6060
Applicant/Permitee: Signature Issued By: Signature