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1738 Flamingo Dr ÿ ÿþ þý þýýü ûúû ùüüýý øÿ÷ þ ìûõÜ õ ääì þý üûúù ø ÷ ö õ ø ôü þ þù ó òü ó ñü ðþ ý þ ÿ þù ýïîí ý ììîì Þþ ðþ ÷ ðÿ éîèèì ÷ù ü ñþ éîèèî öõõô óò ùùþ þ úøó øñ þêðþ ÷ äêþó þ ðöîîÿþ þðöîî ïàîíìä ñ úþõ ñþñþæ þñþùùþþþ ñþñ óþ þþ óùúõñþþùùþ þ ð þ þü þøúÿþ þå þ è ùùþß ó þü ü ú þü � sAGAN TOWNSHIP 3795 Pilot Knob Road St. Pgu1,, Min[�esata 55111 Telephone 454 -5242 PERMIT FOR SEWER SERVICE CONNECTION DATE: 12/2 NUMBER 1•fa< OWNER: 3ir1> riar,ito Address ( 1(s` -•11 S 'i eingc neiv& PLUMBER OF PIPE .0 ry cust iron DESCRIPTION OF BUILDING • Industrial Commercial Residential Multiple Dwelling No. of units Location of Connections: Connection Charge Permit Fee 1 t %) f-f1; 1 /J, 1- O/ Street Repairs Total Inspected by: Date Remarks: By Chief Inspector ideration of the issue and delivery to me of the above permit, I , y agree to do the proposed work in accordance with the rules and ationa of Eagan Township, Dakota County, Minnesota By tro {. , , ._ .. v . , • . • lircn icCormick notify when ready for inspection and connection and before any portion •rk is covered. T>f- Use BLUE or BLACK Ink For office Use 1 1 1 1~ U~~I 1 1 V Of 1 Eano n 1 Permit Fee: 1 City 3830 Pilot Knob Road 1 1 1 Eagan MN 55122 Date Received: 29 1 f Phone: (651) 675-5675 1 1 Fax: (651) 675-5694 1 Staff l_----------------- 1 03 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Unit Date: (0 . - _ 1 3 Site Address: _731o, 1-73T 1 7y0 / 7 4a ~laov.,.,sp be. 1 Name: Phone: t Resident/ QWn@C Address / City ! Zip: I a Applicant is: Owner Contractor 1 Type of Work Description of work: 11 § Construction Cost:Muni-Family Building: (Yes A 1 No ) ~ Company: -~~'lAtrt F.S~~~J' o^S Contact: c' Address: City: Contractor i ~~r'r ~3a ~qoO State; M Zip: ~)45-13 Phone: i r - { ( License tp ib q Lead Certificate F3T- ac, :2 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 fast 12 months, has the City of Eagan issued a permit for a similar plan bared on a master plan? _Yes -No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor. Phone: 6 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.- _ w a CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protecti:-n against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. I hereby acknowledge that this information is complete and accurate; that the wort 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. Applicant's Printed Name Applicant's Signature Page 1 of 3