1529 Greenwood Ct NRESIDENT)
OWNER
Name: iuYrt'� VA r q *s T[a,i� w ly R2LC>G Phone: r •�5. - ?3 I - I 1 3 3
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Address / City /Zip: (o 13 $ a\- �PSf c - 1 V
Applicant is: Owner . Contractor
TYPE OF WORK
Description of work; Cc' CC*
Construction Cost 1? Dci • UU Multi - Family Building: (Yes / No _)
CONTRACTOR
Company: S c' -Ck, 2bo ni 4- &vrlcde.)1 ✓ Contact Kgrr j1
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Address: L ((CU F:XCr,A Sl a g\ i 1 J City_ 5t ( L At3 Park_
State: 'jY\Y\ Zip: S 5k-11 `v Phone: Cj 6 d.. -c l 1 5 -- - . L
License #: C 1 ()C01 0 50 Lead Certificate #: AfA 1 — a 5 (33 i / ` 1
If the project is exempt from lead certification, please explain why: (see Page 3 for additional Information)
In the last 12 months,
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 12:37PM Sela Accounting No. 1661 P. 13
Date:
City of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone; (651) 675 -5675
Fax: (651) 676 -5694
Applicant's Printed Name
For Office Use
Permit*:
r+7
Permit Fee:
Use BLUE or BLACK Ink
bate Received:
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
8 /1 /1
Staff:
Site Address: 15 9 Greenwood C�h ( unit #:
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.gooheratateonecall.org
1 hereby acknowledge that this information is complete and accurate; that the work will be In conformance with the ordinances and codes of tha City of
Eagan; That 1 understand Ihis 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 (he 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 150
days of permit Issuance.
Applicant's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA132569
Date Issued:08/21/2015
Permit Category:ePermit
Site Address: 1529 Greenwood Ct N
Lot:8 Block: 04 Addition: Surrey Heights 1st
PID:10-73000-04-080
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
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 (WS &/or WH)$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 -
Joseph R Adrian
9760 Alaureate Tr Ct
Inver Grove Heights MN 55077
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature