4693 Lista Pt CITY OF EAGAN WATER SERVICE PERMIT
1395 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:
1 agree to comply with . City of Eagan Surcharge:
Ordinances. Misc. Charges:
Total:
BY Date Paid:
Date of I nsp.: N Insp.:
•
CITY' OF EAGAN SEWER SERVICE PERMIT
3795 Pilot Knob Road PERMIT NO.:
Eagan, MN 55122 DATE:
Zoning: No. of Units:
Owner:
Address:
Site Address:
Plumber: __ - -- -- —
1 agree to comply with the City of Eagan Connection Charge:
Ordinances. Account Deposit:
Permit Fee:
Surcharge:
B y Misc. Charges:
Date of Insp.: Total:
Insp.: Date Paid:
•
Use BLUE or BLACK Ink
r
For Office Use
411b~ Permit#: 1 j
City of Ea Eaii
Permit Fee. 0-7 ✓
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff: I
I I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: / Site Address: TI d 9,1~p3 GSi Unit
79
Name: //JLI /'f t Phone:
Resident/
Owner Address / City / Zip:
Applicant is: Owner Contractor
Description of work: `T/,)
Type of Work
Construction Cost: ~f 4 Multi-Family Building: (Yes / No )
Company:/&4*19'7 Contact:
Contractor Address: City: '67LIA0 0` e -
State: 01/1 Zip: 9 7 Phone: 6Z.2-
License d; ~3 S -"d 4 `7 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:
Mechanical Contractor: Phone:
Sewer & Water Contractor: 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
L conclude that they 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.org
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 Minne State Building Code must be completed within 180
days of permit issuance.
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Applicant's Printed ame pplicant's ignature
Page 1 of 3
Use BLUE or BLACK Mk �
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� Permit Fee: �
3830 Pilot Knob Road � �
Eagan MN 55122 � Date Received: �
Phone: (651)675-5675 I I
Fax: (651)675-5694 i Staff: i
2015 RESIDENTIAL BUILDING PERMIT APPLICATION
Date:��—��Site Address:�6`'�j' �/��� �j/G�9 �S7'/� �T Unit#:
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��' ��� �� Description of work: ���
Type of Work ;
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���"' ������ Company:�����1'I �dh?� ��'1/ Contact: /�Lt. �,� 7`'i0,�'�L'
���Contractor�� Address:_ J��.D� ���'��LI� � c�ty: �/�c�'�'.��1ii�'�-e
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� .= ���` State� 1°� Zip: Phone: o�� '-" °Email:
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� �' License#:�3�t� C` 7 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:
Mechanical Contractor: Phone:
Sewer&Water Contractor: Phone:
��NO�TE�Plans and�supportrng,docu�i�ts that you�bm�t are`�cansrder�af�o�be�pu�lic►nfa�rm��;�on�,Pa�r#ia'ns�'a _�
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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. wvuw.qopherstateonecall.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 �7 'Pi" � x
Appl nYs Printed N me �cant' ignature '�,
Page 1 of 3 �
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA144816
Date Issued:08/10/2017
Permit Category:ePermit
Site Address: 4693 Lista Pt
Lot:3 Block: 09 Addition: Ridgecliffe 3rd
PID:10-63982-09-030
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater & 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 -
Brent E Johnson
4645 Summit Pass
Eagan MN 55122
(952) 261-1265
Appliance Installers Of Mn
14105 Rutgers St NE
Prior Lake MN 55372
(952) 469-8341
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA157498
Date Issued:08/22/2019
Permit Category:ePermit
Site Address: 4693 Lista Pt
Lot:3 Block: 09 Addition: Ridgecliffe 3rd
PID:10-63982-09-030
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
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 -
Brent E Johnson
4645 Summit Pass
Eagan MN 55122
Elander Mechanical
645 Shenandoah Dr
Shakopee MN 55379
(952) 445-4692
Applicant/Permitee: Signature Issued By: Signature