4304 Clemson Cir CITY OF EAGAN
WATER SERVICE PERMIT
3830 Pilot Knob Road
P.O. Box 21199 PERMIT NO
Eagan, MN 55121
Zoning: DATE:
Owner:
No.ofUnits:
Address:
Site Addess: •
r: CI .
Plumber ?IIlisSr, , �'
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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 fiJ Date Paid:
Date of Insp.: _ _.� a� - 8
Insp.:
CITY OF EAGAN SEWER SERVICE PERMIT
3830 Pilot Knob Road
P.O. Box 21199- PERMIT NO.:
Eagan, MN 55121
Zoning: DATE:
No. of Units:
Owner:
Address:
Site Address:
Plumber
I agree to comply with the City of Eagan Connection Charge:
Ordinances. Account Deposit:
Permit Fee
B Surcharge:
y Misc. Charges:
Date of Insp.: Total:
Insp.:
Date Paid:
Use BLUE or BLACK Ink
; . I For Office Use
Permit I
City 0f Ea ~Il I Qa
Permit Fee:
3830 Pilot Knob Road j j
Eagan MN 55122 I Date Received:
I I
Phone: (651) 675-5675
Fax: (651) 675-5694 1 Staff: 1
I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 9/,';Q2/2 Site Address: 1 N Unit
Name: 1 F~8 b r-1'r no, 20~415 ~-g J ~ Phone:. 7~(.7. 7S ~
' Resident/
i Owner Address / City / Zip: t? ~s P
Applicant is: Owner Contractor a D ~J t <v
Type of Work Description of work: h fi ` ~ ~C el~j O f7t~
- Construction Cost,r~ Sd c~ n„Iti_1 arxtiLyitieg: ( TPtj -
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Company: ~rL8 Contact:
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Address: City: VMn '<,e (Lo
Contractor s
I State: Zip: Phone" Lee6nse ~
ea e i e
If the project is exempt from led certification, please explain why: (see Page 3 for additional information)
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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
L 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.aooherstateonecall.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 State Building Code must be completed within 180
days, f permit issuance.
X. e
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Applicant's Printed Name Applic na re
Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA163102
Date Issued:08/17/2020
Permit Category:ePermit
Site Address: 4304 Clemson Cir
Lot:28 Block: 02 Addition: The Trails Of Thomas Lake
PID:10-75865-02-280
Use:
Description:
Sub Type:Fireplace
Work Type:Gas Fireplace (new)
Description:
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to
concealing.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 3,000.00
Fee Summary:BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
$90.00 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 -
Karen Jones
4304 Clemson Cir
Eagan MN 55122
(952) 513-7706
Glowing Hearth And Home Llc
100 Eldorado Dr.
Jordan MN 55352
(952) 492-9276
Applicant/Permitee: Signature Issued By: Signature