4535 Mallard Tr S SEWER & WATER PERMIT OFFICE USE ONLY
CITY OF EAGAN METER # PERMIT DATE 09/04/90
3830 Pilot Knob Rd. 11612
Eagan, MN 55122 -1897 CHIP # PERMIT
METER SIZE B.P. RECEIPT # C.57
DATE August 27, 1990 ISSUE DATE B.P. RECEIPT DATE 08/31/90
PRV BOOSTER PUMP
SITE ADDRESS 4535 South Mallard Trail PERMIT REQUESTED
LOT 9 BLOCK 3 SEC /SUB Thomas Lake Woods
X SEWER WATER TAPS
APPLICANT: Thomas Lake Development, Ltd.
ADDRESS: 6648 Rustic Rd. S. E . COMM /IND X RESIDENTIAL
CITY, STATE Prior Lake MN ZIP 55372 X NEW EXISTING
PHONE: .
447-2424
Lawn Sprinkler Meters are to be Installed
PLUMBER: Genz —Ryan Plumbing & Heating Ahead of Domestic Meters on Water Line.
ADDRESS: 14745 South Rober Trail Credit WILL NOT be given for Deduct Meters.
CITY, STATE Rosemount, MN
ZIP 55068 //
PHONE: 423 -1144 X Lb sus .
I AGREE TO OMPLY WITH CITY OF
OWNER: Thomas Lake Development, Ltd. EAGAN ORDINANCES
ADDRESS: 6648 Rustic Rd. S. E.
CITY, STATE Prior Lake, MN Zip 55372
PHO E: 447 SIGNATURE
SIGNATURE WHEN METER ISSUED
PLC A E 0 WORKING DAYS FOR O CESSING CALL 4543220 FOR INSPECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT. 7 /l 9 /6,0
r - - - - - - - - - - - - - -
I For Office Use j
Permit
City of Ea ~ I I
I Permit Fee: Ii .as I
3830 Pilot Knob Road I
Eagan MN 55122 Date Received: I 3 I
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff:
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2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address:
Unit
.
S' s
Nam
e. qS`3 Phone.
Resident/
Owner Address / City / Zip: 1 d ~r 1 ,G~f a
Applicant is: Owner Contractor
Type of Work Description of work: h-G r'o0
Construction Cost: J ooo &0 Multi-Family Building: (Yes / No )
Company: Contact: /1t'`v FEI- 6
IN 01
Contractor Address: vc ity: LO'/~C(
State: N Zip: Phone: alc~ 6 Oe
License SC 63 ` 63 J Lead Certificate
e e project is exempt from lead certification, please explain why: (see Page 3 for additional information)
Fth
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: j
I
Licensed Plumber: Phone:
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Mechanical Contractor: Phone:
Sewer & Water Contractor:_ _ Phone: i
NOTE: Plans and supporfing documents that you submit are considered to be public information Portions o--f- J
the information may be classified as non-public if you provide specific reasons that would permit the City to I
conclude that they 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.gopherstateonecall org
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 issuances.
x
x
Applicant's Printed Name Applicant's Signature
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