3151 Alden Pond LaneCity of Ea all
3830 Pilot Knob Road
Eagan MN 55122
Phone: (631) 675-5675
Fax: (651) 675=5694
1444
RECEIVED
DEC 21 1011
Use BLUE or BLACK Ink
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Permit Fee: •°)
Date Received:
Stats:
Penults:
�,/ 2011 RESIDENTIAL PLUMBING PERMITAPPLICATION
Date: •Is//'/r/ Site Address: C3/' /cPlAtI
Tenant
RESIDENT! OWNER
CONTRACTOR
Name: 1�i�JC m i `' nP r
Suite it
Address l City / Zip: <3 61 Miley, , c 4
oh
Phone: 5/57— 675
Name: _11!IILBERT COMPANY INC.dba CULLIGAN WATER
Address: 1801 50Th ST EAST
State: MN Zip: 55.077'
Contact BILL.MILBEat71. Email:
Phone:
cite . INVER GROVE RC TS
65,1 .451;-2241
TYPE OF WORK
fiL New Replacement _ Repair Rebuild _ Modify Space _ Work in.R.O.W.
Description otwork:.
PERMIT TYPE
RESIDENTIAL
Water Heater
' Lawn trrlgatign L RPZ /_
Septic System
New
_ Abandonment
, 'Water Softener
Add Plumbing Fixtures ( Main / _ Lower Level)
Water Tumaround
RESIDENTIAL FEES:
555.00 Minimum Water Heater, Water Softener, or Water Heater Softener (includes 55.00 State Surcharge)
535.00. Lawn Irrigation (inciddes $5.00 State Surcharge)
555.00 Add Plumbing Fixtut'es, Septic System Abandonment, Water Turnaround* (includes 55.00 State Surcharge)
'Water Tumaround (add 5166.00 if a 5/8" meter is required) •
5105.00 Septic System (510.00 per as built) (includes County fee and 55.00 State Surcharge)
595.00 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $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 utilities.• www.000herstateonecattorr
I hereby acknowledge that this hrfbrmatton b complete and accurate; that the work will be In conformance with the ordinances and codes tdf the City of
Eagan; that I understand this is riot a permit, but only an application' fora permit, and work Is not to start without a permit; that the work will be in
accordance with the approved plan In the cased work which __mire kreview and approval°,
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Applicant's Printed Name
x
Appff gnature
SCANT:.- , Ros+ wood ; #
1711 N.
STATE Rosevil e
NE 631-3.254'