4542 Mallard Tr S SEWER & WATER PERMIT OFFICE USE ONLY
CITY OF EAGAN METER #! PERMIT DATE 09 12 91
3830 Pilot Knob Rd. %'A1 9
Eagan, MN 55122 - 1897 CHIP # PERMIT # '� L. •
METER SIZE B.P. RECEIPT # C 9909
S . 4 , 1990 ISSUE DATE B.P. RECEIPT DATE 09/12/90
DATE
% PRV BOOSTER PUMP
SITE ADQ RESS 4542 South Mallard Trail PERMIT REQUESTED
LOT 16 BLOCK 3 SEC /SUB Thomas Lake Woods
X SEWER X WATER TAPS
APPLICANT: Thomas Lake Development, Ltd.
ADDRESS: 6648 Rustic Rd. S. E. COMM /IND � � 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 & H ati ng Ahead of Domestic Meters on Water Line.
ADDRESS: 14745 South Robert Trail Credit WILL NOT be given for Deduct Meters.
CITY, STATE Rosemount, MN zip 55068
PHONE 423 -1144 ” ,
AGREE TO COMPLY WITH CITY OF
OWNER: Thomas Lake Development, Ltd. EAGAN ORDINANCES
ADDRESS: 6648 Rustic Rd. S. E.
CITY, STATE Prior Lake, MN zip 55372
PHONE. 447-2424 y SIGNATURE WHEN METER ISSUED
PL EE AL W TWO WOR ING A S PR CESSING. CALL 454 -5220 FOR INSPECTIONS. FOR STORM
SEWER P MITS, CONTACT ENGINEERING DEPT. 03f
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA114748
Date Issued:09/18/2013
Permit Category:ePermit
Site Address: 4542 Mallard Tr S
Lot:16 Block: 03 Addition: Thomas Lake Woods
PID:10-76100-03-160
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing
inspection. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes .
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Frederic D Tatting
4542 Mallard Tr S
Eagan MN 55122
Renewal Andersen
1920 County Road C West
Roseville MN 55113
(651) 264-4777
Applicant/Permitee: Signature Issued By: Signature
r _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
I For Office Use
tt I
'"r$to I
Permit
City of Ea
I Permit Fee. 'rJ C1 i
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received: g
Phone: (651) 675-5675
Fax: (651) 675-5694 I Staff:
I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Ad/dress: Unit
Name: Phone:
Resident/ ~ j~ /
Owner Address / City / Zip: A / e-/ d
Applicant is: Owner X Contractor
Type of Work Description of work: er__ D'Ot'
3/111 , 06>0 " &0
Construction Cost: 3 Multi-Family Building: (Yes No.. )
Company: Contact: C
Contractor Address: A"V An-,;' L Vim &1^,J a
State: / Sc ip: G7 Phone: License c 639 (raJ'~;_ Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
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:
1
Licensed Plumber: Phone:
I I
Mechanical Contractor: Phone: I
Sewer & Water Contractor:
Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information.-Portions of T-
I the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets. I
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 issuance.
X ca dC k60 /1) x
Applicant's Printed Name Applicant's Signature
Page 1 of 3
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