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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: I I -----------------I 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: I 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 Page 1 of 3