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3742 Robin Lane y dx r- CITY (F PA Permit No 9171 1(:)72_ ' fi-8- 3830 'Ilot 1p ob Road Meter Na Rate , F , P,O : BoX 9 Si P.O Reader No:,, ; Date _ 5121 Owr er K c. ldrs:. Site Address ,3742 Robin a -9 1 Buck-11107k Plumber `Robert C. W i2ie onn Chg er } 525.00pd Zon R.3 A cct mi R ep Fee. '15la. .00pd d No. of Units: P t ` Surcharge .3OpOOpd I agree to comply with the City of Eagan T r. P lant 180. (X)pd Ordinan Meter. 47 F ,bpd t Misc.: B `0 f WATER SERVICE P MIT 5 CITY GF EAGAN Permit ;, ; , Date: —ry 3830LPilot ob Road B/P 'No: 709 Date: ".1- 43 -87} P.O. Bog i Eaga "Mt55121 i Own r . T, c© `D drs. t 3742 Rct 18 -9 B1 B1ack k Acres j l Site Adds:° -� , £ i Iv WCC: f r 525.00 d + Z City Gtig: 100.00pd ff `t No. of Units: -' 1 A Permit cct, Dep: -$ ° f ! 1 €` 1 agree to comply w ith the City of Eagan Fee . 5Opd Ordinanc Surcharge:` , i � � ' Misc.: BY f SEWER SERVI MIT , For Office Use J al �j *, a ; e e° :::ee: ,„/P EAGAN ,,,,,,,„ .4.4,, 62 t...../ Date Received: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff: buildinoinspections(c citvofeaoan.com L 2018 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: ' �� / da()Site Address: 7r774:71 ® gd,/ ' L c Tenant: Suite#: Resident/Owner Name: Phone: W N Address/City/Zip: Name: 7,-;:r1;514. y U/ / - License#: ,P7fC52- 5 Address: /0118- .5Ce� ,sitz . City: Contractor / / State: /411-/- Zip: 5 / t' Phone: / ��/ P.:52- Contact. 6/7,717 Email:�y .7�� '='t� �� Type of Work —New replacement Repair —Rebuild —Modify Space _Work in R.O.W. vvv Description of work �.� ,- . _ } RESIDENTIAL x ; Water Heater (bWs ater Softener Lawn Irrigation(—RPZ/—PVB) Permit Type Septic System Add Plumbing Fixtures ( Main/—Lower Level) —New Water Turnaround • z Abandonment RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Water Heater and Softener(includes State Surcharge) $60.00 Lawn Irrigation(includes State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment,Water Turnaround*(includes State Surcharge) *Water Turnaround (add$280.00 if a 3/4"meter is required) $115.00 Septic System New(includes County fee and State Surcharge) TOTAL FEES $ �.s CALL BEFORE YOU DIG. Call Gopher Stile-One-Call at(651)454-0002 for protection against underground utility damage.-Cali 48 hours before you intend to dig to receive locates of underground utilities. www.gooherstateonecall.orq You may subscribe to receive an electronic ••tification fro•• the City of proposed ordinances by signing up for an email update on the City's website at www.cit •fea•an.com/subscri•-. I hereby acknowl:.•: that this informatio s corn+tete - d accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I u • and this is not a p rmit, b ' •- an application for a permit, and work is not to start without a pe it; that the work will be in accordance wit - 'proved plan in t case o ,.rk which requires a review and approval of plans. x App1 ( / x ,Q s1iA. . Vs Prin •. Name Applicant's Signature ( 'V- FOR OFFICE USE Reviewed By: Date: - Required Inspections: Under Ground Rough-In Air Test Gas Test Final Meter Related Items: Meter Size Radio Read Manometer Staff: