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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 r________________^ � For Office Use � � � Permit#: � �� � Clt of �a a� � . �� � Y � � Permit Fee: � 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 ��� �i��(� , �� �. �� 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