4676 Salem PtCity of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #: / 0 ! Q L' -
Permit Fee: fe) ' V 0
Date Received:
Staff:
2010 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: q// [ i / Site Address: 4/4 -1 co $ Q bin M PO/%7/
Tenant:
Suite #:
RESIDENT / OWNER
Name: XU 0 n DO G si / %Y b ' 75216
//Phone:
Address / City / Zip: 116 7 b 5 r[ // A M /— !_
Applicant is: Owner "Contractor
TYPE OF WORK
Description of work: 01 (9 / /10/0 14 % P 14 v ()e i) -14S () i tt J 1//) r ops
Construction Cost: / 80 23 Multi -Family Building: (Yes ""/ No )
'I'Hll
CONTRACTOR
At- Horne Services, Inc.
Name: 2690 Cumberland Pkwy, Ste 300 License #:
_
Cumberland Office Park
Address: City:
— Atlanta, GA 30339-3913
State: Lic# 20268257 Ph. 763/ 542-8826 q '? /3 Y S - 6 O t! 7
Contact: J A el 1 Email: O d /,S 1A e ldrr o/).,S . ro in
COMPLETE
In the last 12 months, has
Yes No If yes,
THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
the City of Eagan issued a permit for a similar plan based on a master plan?
date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
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.
CALL BEFORE YOU DIG. Call Gopher State One Cali 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.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.
Schee
Applicant's Printed Name
plicant's Signature
Page 1 of 2
Use BLUE or BLACK Inks
71
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Perm
it #: Q���
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Permit Fee: P - v
3830 Pilot Knob Road
Eagan MN 55122
Date Received:
Phone: (651) 675-5675
I
Staff:
Fax: (651) 675-5694
2010 RESIDENTIAL PLUMBING PERMIT
7 J �fl Lc '_(:_:):11 1
Date: '`� l �l G �" � Site Address:
APPLICATION
tY\ cr-
Tenant: IrIiIiD Suite #:
RESIDENT / OWNER
Name: l� V Phone:
Address / City / Zip:
111 Cp>°,(j
RIR ctn in n5AD_
CONTRACTOR
,
, ,
,
Name:L `� 0X_Xt- C %{�1 ( se #: LQ t 1RC2n. Up 0 .
Address: C- �`- 4, Ve - City: (14 tai
State:W \ Zip: 5 `-1.. L ` , PhoneT 1 c , Ol.y vO U21
Conta Email:
TYPE OF WORK
_ New Replacement - Repair _ Rebuild — Modify Space _Work in R.O.W.
Description of work:
PERMIT TYPE
RESIDENTIAL
Water Softener
Water Heater
Add Plumbing Fixtures ( Main / - Lower Level)
Lawn Irrigation (_ RPZ / = PVB)
Water Turnaround
Septic System
New
Abandonment
RESIDENTIAL FEES:
i
$55.00 Minimum Water Heater, Water Softener, or Water Heater and Softeiner (includes $5.00 State Surcharge)
I
$35.00 Lawn Irrigation (includes $5.00 State Surcharge)
$55.00 Add Plumbing Fixtures, Septic System Abandonment Water Turnarpund*
(includes $5.00 State Surcharge)
*Water Turnaround (add $166.00 if a 5/8" meter is required)
$105.00 Septic System New ($10.00 per as built) (includes County fee and $5.0d
State Surcharge)
$95.00 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $5.00
�a
State Surcharge)
TOTAL FEES $'D
CALL BEFORE YOU DIG. Call Gopher State One CaII at (651) 454-0002 for
protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. w*w.gopherstateonecall.ora
I hereby acknowledge that this information is complete and Accurate; that the work will be in t
Eagan; that I understand this is not a permit, but only an application for a permit, and wor
accordance with the approved plan in the case of work which requires a review and approval o
x V
onformance with the ordinances, and codes of the City of
is not to start without a permit; that the work will be in
p1 s
�`—p -----
Applicant's Printed Name App c
gn-ure
FOR OFFICE USE Revtewed B
Date
Required Inspections: Un�tet`Gt'Ott ltd; Rougfi Iii .AIrT
' `Gas,FeStx I=tnal J f -
I
1
Connection Charge: "'fin`Lfin ?r�
Account Deposit:
Permit Fee-
Surcharge;
ee surcharge;
Misc. Charges: 40 _ ('0 p voter.
Total:
Date Paid:
Imp . 5,
if /(7
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA155649
Date Issued:05/28/2019
Permit Category:ePermit
Site Address: 4676 Salem Pt
Lot:1 Block: 09 Addition: Ridgecliffe 4th
PID:10-63983-09-010
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 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 -
Thanh Trang
4676 Salem Pt
Eagan MN 55122
(651) 246-7528
Home Depot Usa Dba The Home Depot
2455 Paces Ferry Rd
Atlanta GA 30339
(763) 852-1044
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA164546
Date Issued:10/01/2020
Permit Category:ePermit
Site Address: 4676 Salem Pt
Lot:1 Block: 09 Addition: Ridgecliffe 4th
PID:10-63983-09-010
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Standard Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
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 -
Thanh Trang
4676 Salem Point
Eagan MN 55122--263
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature