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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