Loading...
4288 Meghan LaneDate: City of Eaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Tenant: c rat 3 Use BLUE or BLACK 1r, Permit #: Permit Fee: Date Received: Staff: 2011 RESIDENTIAL PLUMBING PERMIT APPLICATION Site Address: y Cr 0rLa-i-L-0--- G ` Suite #: RESIDENT I OWNER Name: 4 t / -I2. t a 4V it' / Phone: g111413 «216 Address / City / Zip: 42. a ine_q^_ V CONTRACTOR Name:MILBERT COMPANY INC.dba CULLIG1AN WATER Address: 1801 50114ST EAST City: INVER GROVE HGTS. State: MN Zip: 55077 Phone: 651 :.451-2241 Contact: BILL.MILBERT t Email: TYPE OF WORK _ Nein Replacement Repair Rebuild Modify Space Work in.R.O.W. _ _ _ _ Description ofwork: PERMIT TYPE RESIDENTIAL Fater Softener Water Heater Add Plumbing Fixtures ( Main / Lower Level) Lawn Irrigation RPZ / PVB) _ Septic System Water Turnaround 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 $166.00 if a 5/8" meter is required) New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) bumed out appliances, ductwork, etc.) (includes $5.00 State Surcharge) TOTAL FEES $ a QG CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. if Call 48 hours before you intend to dig to receive locates of underground utilities.- www.aooherstateonecaliorq I hereby acknowledge that this information is complete and accurate; that the work will be in conformance h = • •• finances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work= not to ; • it; that the work will be in accordance with the approved plan in the case of work which requires a review and ap • •tans 13, ti PLIL2(45t--- Applicants Printed Name equ red 1 spec o s �E `, d r •I r- ou All111111. Applican s Signature City of Eagan Eagan, PERMIT City of Eaan Permit Type: Plumbing Permit Number: EA102718 Date Issued: 01/11/2012 Permit Category: ePermit Site Address: 4288 Meghan Lane Lot: 204 Block: 03 Addition: Meghans PID: 10-48250-03-204 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) $55.00 Surcharge -Fixed $5.00 0801.4087 9001.2195 Total: $60.00 Contractor: Champion Plumbing 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 - Applicant - Owner: Akis Hatzipavlidis 4288 Meghan Lane Eagan MN 55122 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 I*) City of Eaall Date: 3830 Pilot Knob Road Eagan Phone: MN(651) 55122675-5675 RECEIVED Fax: (651) 675-5694 JAN 2 4 2012 Use BLUE or BLACK Ink For Office Use Permit #: Permit Fee: Date Received: Staff: /oaz?37 2011 RESIDENTIAL BUIL()IING PERMIT APPLICATION /,:-=77-7.:= Site Address: u/ (-7-,CaV1 (1 -pi, L,4-16 Name: CASSb1tP,00(M 1;i) 11. l_0/ 5..> Phone: RESIDENT OWNER'. TYPE OF -W Unit #: J Address / City / Zip: Applicant is: Owner Contractor Description of work: RQ ,- Gr 1 iN1Lt SI CAI/2(43/4,0 / f ,v't s E�C Construction Cost: 00 Q Multi -Family Building: (Yes Y / No ) Company: IVITP �t t 1-U► Y I S -tom r� ; Address: l `I5) S (Ou04 rLct State: .Yy\.), Zip: Phone: ContactTT .Fr t*Cc.\i`i /__ City: )00('t/0b0 tra q moi. l % 4-0 License #: S�_Wag. (0355o3 1 Lead Certificate #: If the project is exempt from lead certific tion, please explain why: (see Page 3 for additional information) U(/ /9 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: Mechanical Contractor: Sewer & Water Contractor: NOTE(Plans ;and supporting documents -that you submit are considered to be public information. the information maybe class!fred as non public rf you provide specific reasons that would perm) 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 Buil ina ' ode , st be completed within 180 days of permit issuance. !� frytAsi J. Applicant's Printed Name pp icaan ?.ture Phone: Phone: Phone: Page 1 of 3 9 /IA L� DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation Fireplace Single Family Multi 01 of Plex Accessory Building WORK TYPES New Addition Alteration Replace Retaining Wall Garage Deck Lower Level Porch (3 -Season) Porch (4 -Season) Porch (Screen/Gazebo/Pergola) Pool Interior Improvement Move Building Fire Repair Repair DESCRIPTION Valuation Occupancy Plan Review !/J Code Edition (25%_ 100% '() Zoning Census Code Stories # of Units Square Feet # of Buildings Length Type of Construction VO Width REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile Roof: Ice & Water Final Framing Fireplace: _Rough In _Air Test _Final Insulation Sheathing Sheetrock Reviewed By: Siding Reroof Windows Egress Window 1O-72-37 _ Storm Damage Exterior Alteration (Single Family) Exterior Alteration (Multi) _ Miscellaneous _ Demolish Building* Demolish Interior Demolish Foundation Water Damage *Demolition of entire building - give PCA handout to applicant t-kt MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Meter Size: Final / C.O. Required Final / No C.O. Required HVAC Gas eve Telt__Gas Line Air Test Other: G'C't (L l Pool: _Footings _Air/Gas Tests _Final Siding: _Stucco Lath _Stone Lath _Brick Windows Retaining Wall: _ Footings _ Backfill Final Radon Control Erosion Control , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL ��0 Page 2 of 3