3143 Alden Pond LaneSuitee #:
RESIDENT /OWNER
Name:A i�.�l`l
U tel Al - feu t I Phone: 1.0 Si" to I-7
S' 1
d
Address /City /Zip: Ali i !AI 1 0110 _.0.,A, __/ 1.4 LI
CONTRACTOR
Name: MILBERT COMPANY INC.dba CULLIGAN WATER
Address: 1801 50Th ST EAST c . INVER GROVE HGT
State: ' MN Zip: Phone: 65.1 : :451 -2241
Contact BILL.MILBERT . Email:
TYPE OF WORK
P. New Replacement Repair Rebuild Modify Space Work in,R.O.W.
! _ _ _
Descri • tion of work: -
PERMIT TYPE
RESIDENTIAL
Water Heater ,W ater Softener
Lawn irrigation (,_ RPZ / PVB) Add Plumbing Fixtures L_ Main / _ Lower Level)
_
Septic System Water Turnaround
•
New
_
Abandonment
1 RESIDENTIAL FEES:
335.00 Minimum Water
Heater, Water Softener, or Water Heater will Softener (includes 35.00 State Surcharge)
(includes 35.00 State Surcharge)
Fixtures, Septic System Abandonment, Water Turnaround* (includes 35.00 State Surcharge)
335.00 Lawn Irrigation
$55.00 Add Plumbing
*Water Tumaround
3105.00 Septic System
395.00 Fire Repair (replace
(add 3166.00 if a 5/8" meter is required)
Nei, (310.00 per as built) (includes County fee and 35.00 State Surcharge)
burned out appliances, ductwork, etc.) (includes 35.00 State Surcharge)
TOTAL FEES $
Date:
Tenant:
City ofEa,an pow°
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
Permit #:
Permit Fee:
Date R
Staff:
2011 RESIDENTIAL L PLUMBING PERMIT APPLICA. ION
Site Address: 31 A (24 e I Pon d
Use BLUE or BLACK Ink
i ,
J
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454 -0002 for protection against underground utility damage.
Cali 48 hours before you intend to dig to receive locates of underground utilities. www.aooherstateonecall.org
I hereby acknowledge that this information Is complete and accurate; that the work will be in conformance with e ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application fora permit, and work is to start • ' "� tape , that the work will be in
U)11 i / irt. i t iki --/ x i ■ accordance with therpproved piara In the case of work which requires a review and app . I , f � ,
x
Applicant's P 'rintod Name Appl ant'sSignatu
SEVER & WATER PERMIT OFFICE USE ONLY
CITY I EAGAN
MR # PERMIT DATE $ l 141 Scj � .
3830 Pilot Kral Rd. 148th
'
Eagan, MN 55122 -1897 , WATM:R PERMIT
METER SIZE S.P. RECEIPT # C , 2995
ISSUE DATE B.P. RECEIPT DATE, 7/ 8! 89
T PRV — BOOSTEF3 PUMP
SrrE ADDRE 3143 Alden Pond s ,° . ' valorr REQUESTED
LOT 9 . R QCK ...2 C/SUB
E R . — �1NATER TAPS
':. APPLIt ►I1T,„ '` - o ��ioz 4 . 'Nc,
ADDRESS 1712 W. . ty .Rztad -B _ _ CONMM/InD ` 1 IAL
Roseville, 191
CITY, STATE � ZIP 55113
PHONE: 631 -325 — EXISTING
PLUMBER: j ' Mechaaz cal
ADDRESS 1 0 6 ` 1 s g�I.t_� ". t AGREE TO OOMMPI.Y WITH CITY OF
CITY, STATE Maple .t 'e Zip 55369
EAGAN OR ANCES '
PHONE: 424 - 66811,
OWNER:. 2220 T$m 4 Par tp»r� i
ADDRESS: 1711 W. Coupt9 RA :: 73 . SIGPIATtRtE WHEN MATER ISSUED
, `CIT STATE . Nosi11 �, ' 1 z ip 55113
PHONE: : 4i ?6?g
- ' Qom' // 4.R c. = '
tatitt �� PLEASE if ..
DAYS I PERMITS, tACT
z t DEP A ' ANT BER WILL BE OTII D � a PROCESSED. ;