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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