1449 Lone Oak Rd EAG/N TOWNSHIP ` :
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454 -5242
PEWIT FOR WATER SERVICE CONNECTION
Date: O - (l Number: 329
Billing Name: (LD C G ° l �
Site Address: / 4/1 // d
Owner: . / I . _ Billing Address ,uc-e�i-7, •
Plumber: (e •1 ie..4-7A.4.2
Location of Connection Meter Siz46 /, " io
Connec p n i�nhg. • Vila
Aoct. Deproit . K+• y /a/G9
Meter No.y >4.6' >4' Permit Fee fO
Meter Reading•••,°...' Meter Dep.
Meter Sealed: Yes Add'l Chg.
140 Total Chg.
IInspected by /L-t_-
Date % "4 17 (CI Building is a: Remarks: a'L \
Residence 'V
Multiple No. Units
Commercial
Industrial By: Chief Inspector
Other
In consideration of the issue and delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Township, Dakota County, Minnesota.
By:
WENZEL PI R(; R HT(: INC
1955 SHAWNEE ROAD
SI. PAUL. MINN. 55111
Please notify the above office when ready for inspection and connection.
Clly of Eaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
AFax: (651) 675-5694
Use BLUE or BLACK Ink
1
emeatizto
Permit #: r 1
Permit Fee: C O 00
Date Received:ce�L ) 62 I )2-
Staff: 5
2011 RESIDENTIAL PLUMBING PERMIT APPLICATION
J
Date: Site Address:
Tenant: Suite #:
RESIDENT /OWNER
Name: (� I �0 Phone: ,J2'" -t/SV--5Y/.3
Address /City / Zip: 1 b S L f e Odi
CONTRACTOR
Name: MILBERT COMPANY INC.dba CULLIGAN WATER
Address: 1801 50Th ST EAST City INVER GROVE HGTS
State: MN Zip: 55077 Phone: 651 .451-2241
Contact BILL MILBERT; Email:
TYPE OF WORK
_ New Replacement Repair Rebuild Modify Space Work ir),R.O.W.
_ _ _ _
Description o work:
PERMIT TYPE
RESIDENTIAL
Water Heater Water Softener
Add Plumbing Fixtures L._ Main / Lower Level)
Lawn Irrigation ( RPZ / PVB) _
Water Turnaround
Septic System
New
Abandonment
RESIDENTIAL FEES:
$55.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$35.00 Lawn Irrigation
$55.00 Add Plumbing
*Water Turnaround
$105.00 Septic System
$95.00 Fire Repair (replace
(includes $5.00 State Surcharge)
Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
(add $166.00 if a 5/8" meter is required)
New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge)
TOTAL FEES $ 140: ---
CALL BEFORE YOU DIG. Call Gopher State One CaII 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.aooherstateonecall.orq
1 hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start , ithout a • rmit; that
accordance wit a approved plan i heel"
caseeof work which requires a review and approv I pia
x u 4 MA / rlr/t5ei x i
Applicant's rinted Name Ap cant's Signa ure
e City of
will be in
,$egquredlspect ons;