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4319B Clemson Cir CITY OE EAGAN WATER SERVICE PERMIT 3830 Pit Knob Road P.O. Box 2119J4 PERMIT NO.: Eagan, MN 55121 DATE: Zoning: No. of Units: Owner: Address: Site Addess: - 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: B Date Paid: Date of Insp.: ,w.7° f.. l7 Insp.: CITY or- EACaAN SEWER SERVICE rCr..... . PERMIT NO.: 300 Pilot Knc -5 Road DATE P.O. Box 1 1 21 No. of Units: Zoning: Owner: Address: Site Address: Plumber: h the City of Eagan ronnection Charge: with - c, "Account Deposit` I agree to comply permit Fee: Ordinances Surcharge Miser Charges: Total: By Date Paid: Date of Insp.: Insp.: Use BLUE or BLACK Ink For Office Use x ~.m,~n r 6 I I Permit t City of Eancin ac~ Permit Fee: n 3830 Pilot Knob Road pn Eagan MN 55122 Date Received: I Phone: (651) 675-5675 I 1 Fax: (651) 675-5694 1 Staff: I I t 2013 RESIDENTIAL BUILDING PERMIT APPLICATION . e 1.0 sad Date: l Site Address: 1617 ZL/7/~~St~P2 ~ 319 't-5 l 9 _ Unit 1 Name: f homes 1=K_ Phone Resident/ Owner Address / City / Zip: _ Applicant is: Owner Contractor Description of work: &J 14# A66 l-ICGe' /Al 7,6 fit!Ce r 0 f/4 S O/n~q i Type of Work t f - Construction Cost:._~ _-lti-Feint Yes ti~to _ t Company: TL8 R,5~a 1 h Contact: O~ " 7L / ~ , N6 city: } j Contractor Address: _ 7 -14 State: Zip:- ~5~G Phone" 440--7q7 . i _ 93 DRO ~ WA ea e i ica e If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) d a~' /fit obe), D(,!~Cv n, f ast+ 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 r~VQrmation may be classified as non-public if you provide specific reasons that would perriiit the Citv to i conclude that theyare 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.org 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 l 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'p'ermit issua e. / 44 c x x Applica s Printed Name Ali-cant's Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA177757 Date Issued:07/18/2022 Permit Category:ePermit Site Address: 4319 Clemson Cir B Lot:3 Block: 2 Addition: The Trails Of Thomas Lake PID:10-75865-02-030 Use: Description: Sub Type:Water Heater 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 - Dianne M Martin 4319 Clemson Cir Unit B Eagan MN 55122--481 Tony's Appliance Inc. 2090 County Road 42 West Burnsville MN 55337 (952) 435-2442 Applicant/Permitee: Signature Issued By: Signature