4705 Anne Pt CITY OF EAGAN WATER SERVICE PERMIT
37913 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:
agree to comply with the City of Eagan Surcharge:
Ordinances. Misc. Charges: _
Total:
By Date Paid:
Date of Insp.• -4E" Insp.•
CITY OF EAGAN SEWER SERVICE PERMIT
w
37913 Pilot Knob Road PERMIT NO.:
Eagan, MN 55122 DATE:
Zoning: No. of Units:
Owner:
Address:
Site Address:
Plumber:
agree to comply with the City of Eagan Connection Charge:
Ordinances. Account Deposit:
Permit Fee:
Surcharge:
By Misc. Charges:
Date of Insp.: Total:
Insp.: Dote Paid: _
Use BLUE or BLACK Ink
r
For Office Use
Permit#: I M1
City of EaROD ~aPermit Fee: 410.01
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received: 1
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff: I
I I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Q /2,13/13 Site Address: y161 XJVf'iJ7fC,405" J(7 40,
11704V Unit
Name: IV- Phone:
Resident/
Owner Address / City / Zip:
Applicant is: Owner , K Contractor
Type of Work Description of work: 9e/~C DUI-
Ype
Construction Cost: Multi-Family Building: (Yes -9/ No )
4
Company: f/~~ 1r Contact: 45A M44.4 #401
Contractor Address: 13A0r , aRrie`d e4- City: IS~aXle
AI A State: AI A Zip: ~J7 Phone: ( I A "
License #:2 03 ~4 66 / 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
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.oro
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. ~y
X_ I~ t'049' 430 x
App icant's Printed ame A ant's Sign ture
Page 1 of 3
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA139735
Date Issued:11/07/2016
Permit Category:ePermit
Site Address: 4705 Anne Pt
Lot:3 Block: 01 Addition: Ridgecliffe 2nd
PID:10-63981-01-030
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.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
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 -
Robert E Peterson
4705 Anne Pt
Eagan MN 55122
(651) 688-9141
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA139735
Date Issued:11/07/2016
Permit Category:ePermit
Site Address: 4705 Anne Pt
Lot:3 Block: 01 Addition: Ridgecliffe 2nd
PID:10-63981-01-030
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.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
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 -
Robert E Peterson
4705 Anne Pt
Eagan MN 55122
(651) 688-9141
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature