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4510 Slater RdGity of Eau Date: x Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: Applicant's Printed Name P./'a a 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Site Address: Name: 4 )44 2 Phol4 I-17 �7 -‘ 9 : / 9 / ' / / E' goL.OL Address / City /Zip. � � LY �L-� Applicant is: Owner Contractor /1/a t-/470 ( Phone: Phone: Phone: Applicant's Signature r Use BLUE or BLACK Ink For Office Use Permit #: /d 6 q Permit Fee: Date Received: Staff: Unit #: Description of wo : i C- /--! �' ° v\ DZ6 d Construction Cost: ( + , od Multi - Family Building: (Yes, / No ) SZ Company d✓a i L i.+� a`- Contact: ( � ..?S /a? // I d Address e -0-. City: (� State: & --)- 24 1-) Zip: "( Phone: 1 License #4g7 r3 t 1 a3_ Lead Certificate #: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) AM Le 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: 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.ciooherstateonecall.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 Building Code must be completed within 180 days o permit issuance. Page 1 of 3 WA 1 ER SERVICE PERMIT TY EAGAN 4 052 , 379S, 1tnob Rood P ERMIT NO.; 1 / 1 / 53122 D 1/2 duplex RIII Zoning: Na of U Owner: Zachman Homes Address: 4510. Slater Road Site Address:. Unit A L3 B4 Cinnamon Ridge plumber: St Paul Utilities l ocator. No.: Connection Charge: 335.00 pd Size: Account Deposit: 10.00 pd Reader No.: Permit Fee: .50 pd 1 ogre* to comply with the City of Eagan Surcharge: 60.00 pd meter Ordinances. Misc. Charges: Total: By Dote Paid: Date of Ins .. / 7. tr/ . Insp.: IfiTY EAGAN ' . SERVICE PERMIT 37, `Kne4 R. .', � e, N °f33122 PERMIT NO.: 4986 ZonirS�; DATE: N z Owner: Za _ , - _ Humes N es Q�Wfi its: du. lex Address: - H -- ts-r • - • Site Address: • 4 INIMEMIgr: Rid:e Plumber: St / Pa Uti1 ties 1 agree to comply with �i, Ba l 3 I 100.00 pd OrdMunees. Act n n c e sit. nd I wurA sit: Y —_____ G o Prmit Fee: 10.00 d By Dote of Surcharge: .50 d . Y�� Misc. Charges: Insp.: / Total: • Dote Paid: 1 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA120364 Date Issued:02/05/2014 Permit Category:ePermit Site Address: 4510 Slater Rd Lot:031 Block: 04 Addition: Cinnamon Ridge PID:10-17400-04-031 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Kris Oien 3670 Dodd Rd Eagan, MN 55123 Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087 Surcharge-Fixed $5.00 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 - Ryan M Hartos 13049 Elderberry Ct Apple Valley MN 55124 Champion Plumbing 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 Applicant/Permitee: Signature Issued By: Signature