3545 Blue Jay Way - unit 101City of Ea�all
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
Date: \`" 1 D 1 Site Address:
RESIDENT./
OWNER
TYPE OF WORK
SCN titi°
Permit Fee:
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
For Office Use
Permit #: l b'2:2— P2:2_
C o .oe l
Date Received: Y k 1 2� ` 4
Staff:
Name: . LCC,N tJ F Q �,� Phone: (p 60-3=4
Address / City / Zip: " � LVZSNA �N r 1 b A ;
Applicant is: Owner _xi Contractor
Description of work:
Construction Cost:
AIL • _■ h d W3CJl
Multi - Family Building: (Yes
Company \ �.T�. .71 ND R.A,C, b +J Contact: lk: F,
Addressa..a4 \ � �` � % S 1 s 'TN City: L ��c• j L.LE
State: '\rr Zip: Phone: ' ( ` —L\
License #: C .fa \DA1 Lead Certificate #: QAT • l a.
If the project is exempt from lead certification; please explain why: (see Page 3 for additional information)
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:
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
c onclude that the are trade secrets
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.00pherstateonecall.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 of permit issuance.
xJG4\1 1\)1
Applicant's Printed Name
COMPLETE TH ` AREA ONLY IF CONSTRUCTING A NEW BUILDING
FAX
A Xr"
i
Use BLUE or BLACK Ink
Unit #: I 0
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Page 1 of 3
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA148570
Date Issued:04/09/2018
Permit Category:ePermit
Site Address: 3545 Blue Jay Way 101
Lot:145 Block: 04 Addition: Lexington Place 2nd
PID:10-45051-04-245
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Softener
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.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
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 -
Glen A Ford
20953 Negril Ct
Lutz FL 33558
Tony's Appliance
2090 County Road 42 West
Burnsville MN 55337
(952) 435-2442
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA158838
Date Issued:11/05/2019
Permit Category:ePermit
Site Address: 3545 Blue Jay Way 101
Lot:145 Block: 04 Addition: Lexington Place 2nd
PID:10-45051-04-245
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Standard 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.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
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 -
Glen A Ford
20953 Negril Ct
Lutz FL 33558
(612) 860-3224
Bruckmueller Plumbing Inc
3992 Pennsylvania Ave
Eagan MN 55123
(651) 686-6696
Applicant/Permitee: Signature Issued By: Signature