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4301 Clemson CirCITY OF EAGAN Permit No' Date: 3830 Pilot Knob Road Meter No: Size- P.r;. Box 21199 Reader No: Date' Eagan, MN 55121 Owner Site Address' Plumber: Conn. Chg: Zoning. Acct. Dep: No. of Units. Permit Fee. Surcharge. 1 agree to comply with the City of Eagan Tr. Plant Ordinance Meter v7 Misc • By � Q WATER SERVICE PERMIT ciTY OF EAGAN SEWER SERVICE PERMIT 3830 Pilo! Knob Road PERMIT NO.: P.O. Box 21199 Eagan, MN 55121 DATE: Zoning. No. of Units: Owner: Address. Site Address. Plumber I agree to comply with the City of Eagan Connection Charge: Ordinances. Account Deposit: Permit Fee: Surcharge: By Misc. Ch rges: Date of Insp.: Total:, Insp.. Date Paid: r 4,hi. City of Eagsall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 r Use BLUE or BLACK Ink For Office Use Permit #: / -7V(7 Permit Fee: (7_ a c) Date Received: Staff: 2012 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: I D 1 tom' 1Z- Site Address: 4 30 \ CA t?.(sc e (\r Tenant: Suite #: RESIDENT / OWNER Name: ) e (` beds(' 1 L Phone: Address/City/Zip: L€3nk CAe_..,sZ.,a Q.. e .),,,,,, X1'1v 4.,3 tzz- CONTRACTOR Dl'-,ikoct-,,pr,- Name: A- ,Z vl s– F:3 m „c• vrc < License #: QG c7t,`i 1 i t Address: 3s- .5 b . 2--caS .:, City: V‘. -S State: Pew,' Zip: sib to Phone: & . t L S 7 07- 6'Z, pr-. 5 :1--:‹Aai,a-k1. 10- CIA) t . t :,r,-. Contact: I b a...� NOet. , Email: TYPE OF WORK .' New .6eplacement Repair Rebuild Modify Space Work in R.O.W. — _ _ _ _ Description of work: 2%-ro c. c c e-.),..* �s.}-‘,;,1 w cJr ev S;, vr PERMIT' TYPE RESIDENTIAL Water Heater Water Softener Lawn Irrigation (_ RPZ / PVB) Add Plumbing Fixtures (_ Main / Lower Level) _ Septic System Water Turnaround New Abandonment RESIDENTIAL FEES: $60.00 Minimum Water Heater, Water Softener, or Water Heater (includes $5.00 State Surcharge) Fixtures, Septic System Abandonment, Water and Softener (includes $5.00 State Surcharge) $60.00 Lawn Irrigation $60.00 Add Plumbing *Water Turnaround $105.00 Septic System Turnaround* (includes $5.00 State Surcharge) and $5.00 State Surcharge) TOTAL FEES $ (add $189.00 if a 5/8" meter is required) New ($10.00 per as built) (includes County fee CALL BEFORE YOU DIG. Call Gopher State One CaII 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 1 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. Applicant's Printed Name Applicant's Si FOR OFFICE USE E Reviewed Required Inspections: Under Ground Rough -In Air Test Gas Test ° Final Date; City of Eaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Permit #: Permit Fee: '.15 Date Received: Staff: 2013 RESIDENTIAL BUILDING PERMIT APPLICATION / o ( 3 Site Address: 11300 0 1-t 3 0 ) 21301 X (_ (,44 O N LS Unit #: J Resident Owner Type of Name: i -f f (5 ©T ' {'1 C)A O5 L -k FT Fi> Phone: 6/ 7'f7 7S/ Address / City / Zip: tl t''e Applicant is: Owner . Contractor Description of work: P,001fIC(' w-l)kA It- Prt- pt ee& j&) aa") 'cC Ql ,5i:0,,- , Construction Cost: ,9,,(--S, �Q_ ..---___ _--..___.__ululti=Facaily..l ti4dfngt fYes--- / Rb- ) % �,� ,( Jc3e.0 a rye 5 Company: 71-8 it' .'w4'�s+� t t..�*""'') h .- r Contact: 40,-1 N6 Address: City:-�7 State: Yk1✓� Zip:' 53k Phone:' '"`"1_ { (47— 751 -License #: B�"L(2 t 1-0? D. NAT- St '3 DS -/O - l Lead-Certiticate #: - If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) A' -^V 7,/ s1D,�, COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last12 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" nd supporting documents that you submit are consrderecl fo'be p 'bloc infar latton 'F the information maybe classified as non publicgif you provide specific_ reasonsa-that would permit t conclude thatthe" 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.gooherstateonecall.orq 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 S te Bui .i . Code m st be completed within 180 days',,ofjpermit issuance. x 0-6-12_k Applicant's Printed Name x App nt's Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA164863 Date Issued:10/09/2020 Permit Category:ePermit Site Address: 4301 Clemson Cir Lot:21 Block: 02 Addition: The Trails Of Thomas Lake PID:10-75865-02-210 Use: Description: Sub Type:Residential 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 - Sph Property Two Llc 1301 2nd Ave N Fl 31 Seattle WA 98101 Perfection Plumbing 9633 211th St W Lakeville MN 55044 (612) 867-1192 Applicant/Permitee: Signature Issued By: Signature