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4690 Lenore Lane WATER Enzyme 1 f ro R PERMIT NO • 374 . U122 DATE 4 /1t? / &I ' No of i I1 . U n t ts: 1 unjt trhs � Orrin Thompson Homes 4590, Lenore Lane 13 M2 Ridge Cliffe ZV ` Ganz Ryan It r..No Connection Chorge: 335.00 pd Size: , Account Deposit: Reader Na Permit Fee: 10.0 R a aid► t . of s Surcharge: . 50 00 , p ct Mist. urges: 60.00 nd meter Total: Date Paid: Of 1 < . �a4 Row 4f, 90 � � w ..... t No. of r°�lln n nzs.e. der o . � �� , , �15ldre� $ 1 4890 Lenore Lane L3 812 Ridge Cliffe IV : Cenz Ryan 3/24/31 23868 100.00 pd with tb City edhew etaismosim Olaege:_ 421 .00 Pct Account [asposit; FMnesit For 1 0 _00 pd BY ✓�' �_ Sun: Mtge: , 50 pd Dote Miec. rfharo' lrsP .; " - Date Paid: 4 Use BLUE or BLACK Ink r For Office Use I / "7/ S l City of E ���� Permit#:Permit Fee: DI 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651) 675-5675 Fax: (651) 675-5694 L Staff: 2017 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: —9`7 7 Site Address: 2-1 9 U r-e-- // Tenant: Suite#: t Name: Phone: 1 Resident/Owner I Address/City/Zip: Name: ifres4.r /L974. r-1,13 i..,--D / LLC License#: `2 6 Address: l 2 41 L i-- -(//e--' City: C ti` ' Contractor _ / _ State: I"Z-N Zip: JI) /2 Phone: C� t7— 7 '.7 '( - ‘I C Contact: e�s-�r Email: VT-"S.04y &e.S4 'p/ 61-'.. New _Replaceme _R pair _Rebuild Modi y Space _Work in R.O.W, Type of Work — ��` 1 Descri•pti•on of work C [(J//r RESIDENTIAL I i ? Water Heater Water Softener Lawn Irrigation( RPZ/_PVB) 1 Permit Type Add Plumbing Fixtures( Main/ Lower Level) Septic System — f Water Turnaround New S 4 e Abandonment RESIDENTIAL FEES: 3 $60.00 Water Heater, Water Softener, or Water Heater and Softener(includes State Surcharge) s $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 $ 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.qopherstateonecaltorq 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 • • -• x /?US /V .6';✓` -ke- , 1--, x I` Applicant's Printed Name Applicant's Signature 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: