4204 Malmo Pl CITY 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:
1 agree to comply with the City of Eagan Surcharge:
Ordinances. Misc. Charges:
�/ / Total:
By /" 17-- et Date Paid:
Date of Insp.: 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:
By Misc. Charges:
Date of Insp.: Total:
Insp.: Date Paid:
12/04/2014 14:23 9529857738 �LL SONS EXTERIORS PAGE 02/02
Use SLUE or BLACK Ink
� For OHlce U9e ^ r ^ I
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I
• j Perml[#: �I
C�ty of Ea�aIl � �
� Perrnd Fee: �
I �
3830 Pilot Knob Road I �
Eagan MN 55122 � Date Received: �
Phon•:(651)675-s675 � �
I Staff: �
Fax:(651)676-5694 � i
�-------------------�
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: � Site Address: -\�U L� '1Z� ��\ � Unit#:
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IP the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
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COMPLETE THIS AREA ONLY IF CONSTRUCTING A N�W BUILDING
in the last 12 months,has the Clty of Eagan issued a permlt for a similar plan based on a master plan?
Yes _No If yes, date and address of master plan;
Liceneed Plumber: Phone:
MeChanical ContraCtor: Phone:
Sewer�Water Contractor: Phone:
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CALI.BEFORE YOU DIG. Call Gopher 8tate OnA Call at(651)454-0002 fo�protectlon againet underground utlllty damage. Cafl 48 hours
before you intentl to dlg to receive locates oF�mderground ulilities:www aoQheretateonecall.Qrs .
I hereby edcnowledge that thls Information Is complete and accurate;that tne work will be in conformance with the ordinances and codes of the Cify of
Eagan; that 1 understand lhls Is nof a permlt, but only an appllcation for a pertnit and work Is not to s1aR without a permit;that the work will be in
accoMancs wlth the approved plan in the case of work whiCh requires a review and approvat of plans.
Exterlor work autftorized by e building pormit i&6uad In accordanc wlth the M� sota S B dl Coda must be comploted wlthin 9 BO
days ot permlt i9sudncA.
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AppllcanYs�ted Nam A Ilcant's re
.
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