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1578 Mallard View
• &WAT R PE �E 0ILY .� :CM IAN 1. METER # PERMIT DATE 5/1.6/89 *SO -Pilot "Knob Rd. Eagan, MR5512.2489 # W ATER r i s METERSIsE �' p ?. RECE IPT.# € C 1916 ISSUE DA "; t.P. RECEIPT ;EIP"T SFTE SS 'r":7i ' 919' / / ' . _ t�EouEsit LOT BL DCK � ' � ti < _ TArg APpucAPIT:.:_ o .,; 6- 6 - EWER WATER , — AE RESS 1 � I .! r #9 / ,. v %�- 011AM�II+IIJ ' A Pllow °''s � b "' y NEW EXJST1 PLUMBER, tr, irefta R "f AGREE To COMPLY WITH t1 oP '. CITY; STATE- ... " 2 x AIN ORtgli PEE: OWNER: OM ! n � .1" s S SIGNATURE WHEN CITY, STATE 'i`i� �• • /. .: ap pry, E. 4if PLEASE:ALL 4, T` ° ► N . 1 7 • . WI. FOR 0 M , 'ACT '� NF c' i? v yr} � .�� / r - - - - - - _ _ I For Office Use 1 I I 91 1 City of Ea (]j~ Permit I Permit Fee: _ "7Al a~ I 3830 Pilot Knob Road I Eagan MN 55122 Date Received: Phone: (651) 675-5675 1 I Fax: (651) 675-5694 I Staff: I 1 I------------ 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: p / p Unit Name: Phone: Resident/ Owner Address/ City/ Zip: Applicant is: Owner Contractor Type of Work Description of work: ea ✓ot) Construction Cost: ©oo CIO Multi-Family Building: (Yes / No ) Company: -13 dC~ ~j^w~ Contact: let, F✓'~L D,C~ Contractor Address: 3300 j~lJ T Ve "A ity: V '/'(P`/ State: ~ Zip: Phone: ` 63 00 License Sc, 63 ` 639- 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? I _Yes _No If yes, date and address of master plan: I~ Licensed Plumber: Phone: i Mechanical Contractor: Phone: 1 - i Sewer & Water Contractor:______ _ Phone: NOTE: Plans and supp_orfing 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 I conclude that they are trade secrets, j 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. wNw.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.1 x 4,0 k601,) x Applicant's Printed Name Applicant's Signature Page 1 of 3