4682 Lista PtCITY OF EAGAN WATER SERVICE PERMIT
3795 Pilot Knob Road PERMIT NO •
Eagan, MN 55122 DATE•
Zoning: No. of Units:
Owner:
Address:
Site Address:
Plumber:
Meter No.: — Connection Charge:
Size: Account Deposit:
Reader No.: Permit Fee•
agree to comply with the City of Eagan Surcharge:
Misc. Charges:
Total •
Date Paid:
of Insp.: /° /_5 Insp •
Ordinances. /
c
Date
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CITY OF EAGAN
3795 Pilot Knob Road
Eagan, MN 55122
Zoning:
Owner:
Address:
SEWER SERVICE PERMIT
PERMIT NO.:
DATE:
No. of Units:
Site Address:
Plumber:
I agree to comply with the City of Eagan Connection Charge:
Ordinances. Account Deposit:
Permit Fee:
Surcharge•
By Misc. Charges -
Date of Insp.: Total:
Insp.: Date Paid:
leitt°
C!ty of Earn
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
r
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee:
Date Received:
Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: !1 ?v1 3 Site Address: %'%? I419% flUTO 1 yL1t,yLFo GSA Pt- Unit #:
Name: 21d'l°Ci-f 5
Phone:
Address / City / Zip:
Applicant is: Owner Contractor
Description of work: --f-/O �� "' re.)L
Construction Co
zy o v
Multi -Family Building: (Yes / No )
Company: -6,212C kt Prikt-'e /+-t P Contact:.L�e N.
Address: I LIDS-gleirTle-s' Ot
State: Zip: cf3 ?7Phone:
License #:3 FU C4.7
city: I ieNCI4.1Cp
Lead Certificate #:
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Phone:
Sewer & Water Contractor: Phone:
Mechanical Contractor:
NOTE:`Plans and supporting documents ilia
the information may be classified as non -pi
►bmit are considered to be public information.
ou provide specific reasons that'%rould perinif
tiey are trade secrets
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.
Pi
Applican s Printed Name
x
Appli s Sig ure
Page 1 of 3
41°
City of Eapi
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee:
Date Received:
Staff:
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: V-"" 7 --(/ Site Address: 14 7,gL8'% Ihniteri y17F %412 664 i" Unit #:
Resident/
Owner
Name: IID 6 e (L /Fre (c t Phone:
�J�
Address / City / Zip: L_ it41
Applicant is: Owner Contractor
T e Of Work
yp
Description of work: -5/07115
Construction Cost: 0 , (,L;(� Multi -Family Building: (Yes X / No )
Contractor
Company: 0/e/ZC1d'I /-7 4 C'. "1i/ Contact: A `�'1 G-- 41.567V -e "ii
P Y�
/
Address: / 30Q Gs .0/ / e� Gt' City: ge.J/LL1.54/7(! "t'
f/°
State: f � Zip: Sr S— 7 Phone: U!/®1 — F/ t "- 7 P U
X33
License #:42 v /
3 ko G G Lead Certificate #:
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:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
NOTE: Plansand 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.
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.gooherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codeeof 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 ork 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 complete within 180
days of permit issuance.
/ y
e
J''� '/fort x � .rF`
A Printed Nafiew
PP Ap'. cant's gnature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA160690
Date Issued:04/03/2020
Permit Category:ePermit
Site Address: 4682 Lista Pt
Lot:4 Block: 03 Addition: Ridgecliffe 3rd
PID:10-63982-03-040
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description: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.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
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 -
Matthew Kelley
4682 Lista Pt
Eagan MN 55122
(651) 346-8500
Milbert Company (culligan)
1801 50th St E
Inver Grove Heights MN 55077
(651) 451-2241
Applicant/Permitee: Signature Issued By: Signature