Loading...
2107 Cedar Grove Tr, Unit 114 4 Use BLUE or BLACK Ink PennftP City of Eap I , 3830 Pilot Knob Road j Parmtt Fee: C Eagan MN 55122 I Phone: (651) 675-5675 Date Received; Fax: (1351) 6754694 Stab , 2011 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: Site Address: Tenant; suite RESIDENTI OWNER Name: ~Jll1 ~ Phorw --t fL q Address / CRY / Zip: a b ky W I CONTRACTOR Name:_ll!IILBERT COMPANY INC.dba CUWL WAN WATER Address• 1801 50" h ST EAST Cllr : INVER GROVE li= State: • MN_Zip; 55.077' Phone: 65,1 .::451-2241 Contact:- BILI..MILBE'T` Email: TYPE OF WORK _ New _ Replacement _ Repair _ Rebuild _ Modify Space _ Work In.R.O.W. Description wori PERMIT TYPE REOLNT/AL Water Heater Water Softener Lawn Hgation L RPZ / _ PVB) Add Plumbing Fixtures Main Lower Level) Septic System Water Turnaround _ New -Abandonment RESIDENTIAL FEES: $55.00 Minimum Water Hefater, Water Softener, or Water Heater M Softener (includes $5.00 State Surcharge) $35.00 Lawn Irrigation (IncIddes $5.00 State Surcharge) $55.00 Add Plumbing Fixtures Septic System Ab doan rement , Water Turnaround* (Includes 65.00 State Surcha e 'Water Turnaround (apd $166.00 N a 5/8" meter is required) ) $105.00 Septic System V_23~ ($10.00 per as built) pncludes County fee and $5.00 State Surcharge) $95.00 Fire Repair (replace burned out appliances, ductwork, eta) pncludes $5.00 State Surcharge) TOTAL FEES; 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 uanties. I hereby acknowledge flat this Mt~rmsft is complete and accurate; that the work will be in conformance with the ordinances and codes 4 Qa City of Eagan: Owl I understand this Is a permit. but only-an application ,for a permit, and work Is not to start without a por min that the work will be in acdordancs with approved p In the case of work which requires s .review and approval or plans. CI ca0. Applicant's Printed Name Applicant's, igna re FO Q,F CEO SE ev ew R)!eSl isR~ . lCe'r ° . i