1570 Mallard ViewPERMIT TE,
WATER PtIT*,10 8
-METER
SITE ESS 1570
LOT _BLS
APPUCANT: Thom
,ADDRESS:. 6648 ' Rus t±c Road $
arc SWW4TE `,'ria La zip 55372
PHONE. 447_2424
:ard. _ i eta
s Lake
Lak#
Dvi
patent,. Ltd.
tiaER
C en z --Ryag Pmb .ng H
�AQORES 1.4745 .SoDth Rembert ' nazi M 1AGR ' OC Y
CIVi STATE Ros emouit �N N 1p 5068.... : EAGA f
PHONE: 42 3'* 1141
�.oia$ Lake ` i ve'1opment , ,,Ltd .
NESS
48 tic R H. L.
l'rior La i' - 553:/"1
, STATE 44,-24Z4 ,
Clly of Eaaau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
1
For Office Use
`131 Permit #: 110
�r\ I
Permit Fee: 469�
JD'f
Date Received:
Staff:
2013 RESIDENTIAL PLUMBING PERMIT APPLICATION
13 � Ac v �-4v\IMO!1
Date: ` �� Site Address: �
y ( \ son.
Tenant:
Residentl ®wn-
Name:
Address / City / Zip: 1. 5170 q l![. _ y t4e4- J
Suite #:
J
Phone: &V —LC.? •-OTSI
Name: MILBERT COMPANY INC dba CULLIGAN WATER License #: 063031 -WC
Address: 1801 50TM STREET EAST City: INVER GROVE HGTS
State: MN Zip: 55077 Phone: 651-451-2241
Contact: BILL MILBERT Email:
�lfteplacement Repair — Rebuild _ Modify Space _ Work in R.O.W.
ork:
RESIDENTIAL
Water Heater
Lawn Irrigation ( RPZ / _ PVB)
Septic System
New
Abandonment
Plater Softener
Add Plumbing Fixtures ( Main / Lower Level)
Water Turnaround
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener (Includes $5.00 State Surcharge)
$60.00 L awn Irrigation (includes $5.00 minimum State Surcharge)
$60.00 Arid Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
*1,6 iter Turnaround (add $200.00 if a 5/8" meter is required)
$105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
TOTAL FEES $
CALL BEFORE YOU DIG. CaII 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.orq
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 th approved plan in the cas of work which requires a review and approval •f plan-.
x.A_StAtlitii/A .kir" 11.11
Applicant's Signature
City of Eagan
PERMIT
City of Eaan
Permit Type: Mechanical
Permit Number: EA112536
Date Issued: 08/16/2013
Permit Category: ePermit
Site Address: 1570 Mallard View
Lot: 6 Block: 02
PID: 10-76100-02-060
Use:
Addition: Thomas Lake Woods
Description:
Sub Type: Residential
Work Type: Replace
Description: Air Conditioner
Comments:
Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Heather Brockman
21210 Eaton Ave
Fee Summary:
ME - Permit Fee (Replacements) $55.00
Surcharge -Fixed $5.00
0801.4088
9001.2195
Total: $60.00
Contractor:
Controlled Air
21210 Eaton Ave
Farmington MN 55024
(651) 460-6022 X253
- Applicant -
Owner:
Karyl M Wilson Tste
1570 Mallard View
Eagan MN 55122
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.
Applicant/Permitee: Signature
Issued By: Signature
City of Eaaall
3830 Pilo Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
For Office Use
Permit#: `� $` 1
Permit Fee:
54q.a�
Date Received:
Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address:
Unit #:
Resident/
Owner
Name: j - g , iS7co / s--)„, /,C751 Phone:
/ J4 //44 U° e rte° Eat A3 s-s'1�_�
Address / City / Zip:
Applicant is: Owner )( Contractor
Type of Work
Contractor
Description of work: ' t17�'
, ` `��
Construction Cost: °OC) Multi -Family Building: (Yes X / No )
Lli/JC n inr.� Contact: f ' F✓'c `kcal)
Address: 3300EC)'%R-� 6OroL?e A 6 iy: L0//i Lc
State: / IP Zip: �) Phone: aol-
Company:
License #: SG 63/ 63S—
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:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
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.
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.orq
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
Applicant's Printed Name
Applicant's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA170043
Date Issued:06/17/2021
Permit Category:ePermit
Site Address: 1570 Mallard View
Lot:6 Block: 02 Addition: Thomas Lake Woods
PID:10-76100-02-060
Use:
Description:
Sub Type:Residential
Work Type:Alteration
Description:Fixtures
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Fee Summary:PL - Permit Fee (miscellaneous)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 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 -
Peggy L Thomas
1570 Mallard Vw
Eagan MN 55122--255
Hessian Plumbing Services
Box 22172
Eagan MN 55122
(651) 681-8252
Applicant/Permitee: Signature Issued By: Signature