1317 Crestridge LaneRESIDENT /
OWNER
Name: /7/ e-" (,)loll 5 1O1 4 /7 % Phone: 5 ' 7 - 3 /LI —182
Address / City / Zip: / 3 l S C yes r,r /-7. e /14z r,4 7-�. 53 / 2
Applicant is: Owner ' Contractor(n / r / 3 /'7 (3 [ `t / 3.?/ /3.)3 "r /32
TYPE OF WORK
Description of work: - v" e `i k , ievi=
uc/
Construction Cost: d k . ( f0 '" Multi- Family Building: (Yes k / No )
CONTRACTOR
Company: / V D /'(,,J � r C "� 1 . c9 r,. s :°c Contact: • ( rvt /He �Ucr -r'
-
Address: 626--- ml Z '"°7 / G J 44 v`" 1 ."( 2 /'City: 1 Gi &`'2 C
State: A Zip: 5 5 3 (f Phone: 6/2 _ R5 Gi'_ g..5 ✓ '/
- License #: A G 1 CT 7 3 Lead Certificate #:
If the project is exempt
from lead certification, please explain why: (see Page 3 for additional information)
In the last 12 months,
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:
_ Yes
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
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 they are trade secrets.
City of Ea�all
Date:
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
Site Address:
r
Permit #:
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
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 i 1 ki °
Applicant's Printed Name
// "
'App cant's Signatur
Use BLUE or BLACK Ink
Permit Fee: 1 /Z4 7 ' 7 - 5
Date Received:
Staff:
For Office Use
/6 eke �(
Unit #:
Page 1 of 3
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA165890
Date Issued:11/30/2020
Permit Category:ePermit
Site Address: 1317 Crestridge Lane
Lot:5 Block: 02 Addition: Hidden Oaks
PID:10-32750-02-050
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Standard Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
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 -
Leattea Rae Cluchie
52968 790th St
Jackson MN 56143
Tony's Appliance
2090 County Road 42 West
Burnsville MN 55337
(952) 435-2442
Applicant/Permitee: Signature Issued By: Signature