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
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Address / City /Zip. � � LY �L-�
Applicant is: Owner Contractor
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Phone:
Phone:
Phone:
Applicant's Signature
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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: (
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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