3760 Vermilion Ct S. u R.
RESIDENT / OWNER
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Name: Alb 5 0 Oc /L Phone: (P,d p2 G
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Address / City / Zip: , _- 2._ }2/1 / ( d • ' 6Z
CONTRACTOR
Name:.MILBERT COMPANY INC.dba CULLIGAN WATER
Address: 1801 50Th ST EAST city INVER GROVE HGTS
State: MN Zip: 55077 Phone: 651 :.45.1. -2241
Contact BILL .MILBERT� Email:
TYPE OF WORK
New Replacement Repair Rebuild Modify Space Work in.R.O.W.
_ _ _ _
Description of work: .
RESIDENTIAL
water Heater Water Softener
PERMIT TYPE
11
Add Plumbing Fixtures (_ Main / Lower Level)
Lawn lrr3 anon _
g (_ 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 $
Date: 6
Tenant:
Gity of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
x 0 fv t-L °0
Applicant's Printed Name
C iatt -O tga
App cant's Signature
Use BLUE or BLACK Ink
„ar,,ulio..„„te,
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Permit #:
Permit Fee: -1 f 6 540
Date Received:
Staff:
2011 RESIDENTIAL PLUMBING PE MIT APPLICATION
ATION
A
Site Address: ) 7 t)e ( Lief C i/ /1 J'1/ Q'`1. - e i
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.000herstateonecall.orq
1 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 playa in the case of work which requires a review and approval of plans.
-1 4
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From:ALLSTAR CONSTRUCTION 19529427464 09/03/2013 10:11 #482 P.011/043
3 ~ 4$ , 3-7 S-0 3-75,q , 3`7 5-A 5-7 5 (o
3-15 S 1 '3-7 Qo a 1v-7 ba , ~-7 G A . 3-7 4 (1P Use BLUE or BLACK Ink
I For Office Use I
I Q, I
City of Eajan i Permit ` ?213 477
Permit Fee: 13 Of .
3830 Pilot Knob Road 22
Eagan MN 55122 Date Received: 4A i ~J
Phone: (651) 675-5675 1 I
I
Fax: (651) 675-5694 1 Staff: L 12
2013 - - - - - - - - - - - - - - -
d 20113 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: v 2i 2oIJ Site Address: _31"49)- 31 DIP V=MDY1 sWlkJ12 Unit#:
Name: .n,..-:...~~.. Phone:
Resident/
Owner Address / City / Zip:
Applicant is: Owner Contractor
' of Work Description of work: roof -A
Type
Construction Cost:* I , ~0fZ_ Mufti-Family Building: (Yes / No )
Company: /11I Y cAY1SjVUchm MaMexvtunt Contact: JX A sftcl
Address: 5145 IM A A St. S%Ai* # 103 City: I ( h
Contractor
State: Zip: CJcJ3SoI Phone: a -151-0141- 11-,
15H
License M -BCA 10J 7cJ' Lead Certificate M N AT" 2U°II-011-4 -0
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
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:
i NOTE. Plans and supporting documents that you submit are considered to be public information. Portions of
i the information maybe classified as non-public if you provide specific reasons that would permit the City to
conclude that the are trade
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.clopherstateonecall.org
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 Minneso late Building Code must be completed within 180
days of permit issuance,
x lot, 74 1 e%-L--ad x
Appricant's Printed Name Appli s Signat e
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