4456 Cinnamon Ridge Cir CITY OF EAGAN WATER SERVICE PERMIT
3830 Pilot Knob Road PERMIT NO.:
P. O. 'Box 21199
Eagan, MN 55121 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 City of Eagan Surcharge:
Ordinances. Misc. Charges:
Total:
By Date Paid:
Date of Insp.: 5 g 4 Insp.:
CITY OF EAGAN SEWER SERVICE PERMIT
3830 Pilot Knob Road PERMIT NO.:
P. 0:Box 21199
Eagan, MN 55121 DATE:
Zoning: No. of Units:
Owner:
Address:
Site Address:
Plumber: )0.00
6.74. no pd
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:
Oct,18. 2013 9:01AM Crest Exteriors 651-463-8095 P. 28
Use BLUE or BLACK Ink
For Office US
q I
I permit (l: 1
City of Ea '"n I Permit Fee: ld~r 1
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received: j
Phone: (651) 676.5676 I Staff:
Fax: (651) 676-6694
I I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 1 Site Address: - f -unit m
Name: C~ ll~ t ► ~1' [/t Phone:
Address / City/ Zip: ll~ r
' Applicant is: Owner ZConlraetor
Description of work:
O
1 • _j__ Construction Cost: T7 Mulll-Family Building: (Yes _ / No
Company: nQContact:
Address•'? hh ~1 X me y- ~-F NE f e 24 Ity:
,
sR o o 'y Slate: r)N Zip: L11 F). Phone:(-Q I ZZt Z~GO
GO(
License 1; ,C ~.10 Z / _ Lead certificate ff:
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 slmllar plan based on a master plan?
Yes y/No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
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fir.: . ; R t:@;seprets;;
CALL BEFORE YOU DIG. Call Gopher State One Call at (661) 464.0002 (or protection against underground utility damage. Call 48 hours
before you Intend to dig to receive locales of underground utilities. www.QonhersIaleoneca1 &M
I hereby acknowledge that this Informatlon 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 parmll, but only an application fora permit, and work to 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.
Exterlorwork authorized by a building permit Issued In accordance with the Mlnnesota State Building Code must be completed within 100
days of permit Issuance.
x x
Applicant's Printed Name Applicant's Signature
Page 1 of 3
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