3488 Greenwood Ct SRESIDENT 1
OWNER
Name:' t -\ s T "i'N ume. C -&c'.c. '1& -&3H)-33 Phone: 3H)-33
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Address / City 1 Zip: to '-.1 L.�'r / L,Jes — 1 ir_ i y
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Applicant Is: Owner ,, Contractor
TYPE OF WORK
Description of work: le- fC CC> C
p
Construction Cost: 1 off' D9 �� S - 00 Multi- Family Building: (Yes / Na )
CONTACTOR
Company: �� CAA_ 2L�O - \4 11(1 C e-1I1 I Contact: 1`ar''
Address: L {lCO r1 S'1 0 Q 1 V L J City: < Lbi." Pa 1"'l_
State: I Zip: 5 SLI I (v Phone; C 6 J - l 5 -- - 7,1D.
License is C - l C)C)1 U 5 0 Lead Certificate*: /JA T -- & 5 03 L/ —
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
in the last 12 rnonths,
Yes No If
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan Issued a permit for a similar plan based on a master plan?
yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
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 the are trade secrets.
Aug. 1. 2012 12:36PM Seld Accounting No.1661 P. 5
Use BLUE or BLACK Ink
City of Eaall
3830 Pilot Knob Road
Fagan MN 55122 Date Received:
Phone: (651) 675 -5675
Fax: (651) 675 -5694 Staff:
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
Por Office Uee
Permit #: /69 ' -e,5
Permit Fee:
J
Date; VI I / I Z Site Address: 39 S'6 3y8$ 3'/91) 3(4'9 Z., Greenwood C+. S Unit #:
CALL BEFORE YOU DIG, Call Gopher State One Call at (661) 464 -0002 for protection against underground utility damage. Call 48 hours
b efore you intend to dig to receive locates of underground utilities www.g ohersta eonecall.orq
1 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 IVlinnesota State Building Code must be completed within 180
days of permit issuance.
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Applicant's Printed Name
Applicant's Signature
Page 1 of 3
c�
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA127477
Date Issued:10/02/2014
Permit Category:ePermit
Site Address: 3488 Greenwood Ct S
Lot:7 Block: 10 Addition: Surrey Heights 1st
PID:10-73000-10-070
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater & Water Softener
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.
Jennie Wood
1424 3rd St N
Minneapolis, MN 55411
Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087
Surcharge-Fixed $5.00 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 -
Shellene K Joslin
3488 Greenwood Ct S
Eagan MN 55122
(651) 208-0767
Benjamin Franklin Plumbing
1424 N 3rd St.
Minneapolis MN 55411
(612) 604-4285 X61
Applicant/Permitee: Signature Issued By: Signature