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1586 Mallard View CITY OF EAGAN Permit No: Date: 3838 Pilot Knob Road Meter No: Size: P.O. Box 21199 Reader No: Date: Eagan, MN 55121 Owner: Site Address: Plumber: Conn. Chg: Zoning: Acct. Dep: No. of Units: Permit Fee: Surcharge: I agree to comply with the City of Eagan Tr. Plant Ordinances. Meter: ,� Misc.: By h/1l/ 11-16-8g WATER SERVICE PERMIT (F /J CITY 9F EAGAN Permit No: Date: 3830 Pilot Knob Road B/P No: Date: P.O. Box 21199 Eagan, MN 55121 Owner: Site Address: Plumber: MWCC: Zoning - City Chg: No. of Units: Acct. Dep: I agree to comply with the City of Eagan Permit Fee: Ordinances. Surcharge: Misc.: By SEWER SERVICE PERMIT r - - - - - - - - - - - - - QQ 1 i~ Q I For Office Use I City of Ea aPermit#: I I I Permit Fee: 3830 Pilot Knob Road I Eagan MN 55122 Date Received: l Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: I I ~ I 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit ~ -8L ~6 f Phone: Residentl Name: Owner Address /City /Zip: XA/ " A!La/ 6C L,/ Applicant is: Owner I Contractor Type of Work Description of work: F-c i''Ot) Construction Cost: ©0Q ( 00 Multi-Family Building: (Yes / No ) Company: co 111A'r,,0~6ra Contact: G..i F✓~~ `Oti~O,~ d ! Contractor Address: 3? 00 FIV, r J r ity: &A, Ja State: V' P Zip: G-'3- 3 Phone: all - / 6-6300 License Sc, 631(739- 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: { f I Licensed Plumber: Phone: Mechanical Contractor: Phone: I Sewer & Water Contractor: ~ Phone: [-NOTE: Plans and supporting documents that you submit are considered to be public information.-Portions of -4 the information may be classified as non-public Y if you provide specific reasons tho t would permit the City to I conclude that they are trade secrets, j 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. wvAV.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 Minnesota State Building Code must be completed within 180 days of permit issuance. xJ~7 L.) L { bG<~ x Applicant's Printed Name Applicant's Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA152823 Date Issued:11/02/2018 Permit Category:ePermit Site Address: 1586 Mallard View Lot:14 Block: 02 Addition: Thomas Lake Woods PID:10-76100-02-140 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Heater 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 - Michael Tste Klimek 2700 Farrington St Roseville MN 55113 (651) 329-9002 Champion Plumbing 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 Applicant/Permitee: Signature Issued By: Signature