4072 Meadowlark Lane VILLAGE OF EAGAN WATER SERVICE PERMIT
3/95 Piiot'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:
I agree to comply with the Village of Eagan Surcharge:
Ordinan Misc. Charges:
Total:
/ Date Paid:
Date Insp.: f/ Insp.:
VILLAGE OF EAGAN SEWER SERVICE PERMIT
3795 Pilot knob Road PERMIT NO.:
Eagan, MN 55122 DATE:
Zoning: No. of Units:
Owner:
Address:
Site Address:
Plumber:
I agree to comply with the Village of Eagan Connection Charge:
Ordinances. Account Deposit:
Permit Fee:
Surcharge:
B Misc. Charges:-- --s'
Date of sp.: Total:
Insp.: Date Paid:
.
� Use BLUE or BLACK Ink
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� For Office Use �
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3830 Pilot Knob Road I I
Eagan MN 55122 � �
I Date Received: I
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I I
� Staff: �
�-----------------�
2014 COMMERCIAL BUILDING PERMIT APPLICATION
Date: f �IS � Site Address:
Tenant Name: �e�d\�Q v..� \�.�- �:������ (Tenant is: New/ � Existing) Suite#:
Former Tenant:
Name: {° �c scl�+•...�n�- X, r��o �� � � Phone:
Property Owner Address i City�Zip:xl d�t7 . �' ra�2, ►t c��� o 't ��� , 'iv��F. �t �7�t�, �( c��� ,�l ���
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Appiicant is: Owner Contractor �
Type of Work ' Description of work:__s�. Y•t7 !t �r�N� � �t w1 t-^�
Construction Cost:�/�.LW �
Name: C� Y�vr�.c�� �r� ` pv.��l��c.�w� License#:
Contractor Address: Z �°7'� �/�'���,�,,,� U r. city: �; ,�q�,�
State: �1 � Zip:_�S 3 r�' b Phone: G S� � ��� �— �ti � �
Contact: %he �'�'� e� Emai�: .,. � ,� �nt� �O L_`�,�v..�
Name: Registration#:
�Architect/Engineer Address: City:
State: Zip: Phone:
Contact Person: Email:
Licensed plumber installing new sewer/water service: 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
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.gopherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the w k w I be in conformance with the ordinances and
codes of the City of Eagan; that I understand this is not a permit, but only an ap c tionifor 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 r wh' h requires a review and approval of plans.
X `� e ��-� gv� S �e`�) x
Applicant's Printed Name ApplicanYs Sig
Page 1 of 3
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA174578
Date Issued:02/04/2022
Permit Category:ePermit
Site Address: 4072 Meadowlark Lane
Lot:002 Block: 04 Addition: Hillandale 1st
PID:10-32950-04-002
Use:
Description:
Sub Type:Water Heater
Work Type:Replace
Description:Standard Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
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 -
Jacob Knott
4072 Meadowlark Ln
Eagan MN 55122
Champion Plumbing Llc
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature