1521B Clemson Dr CITY OF EAGAN WATER SERVICE PERMIT
3795 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:
1 agree to comply with the City of Eagan Surcharge:
Ordinances. Misc. Charges:
By
@/- 5`,/, Total:
Date Paid:
Date of In .: Insp.:
CITY OF EAGAN SEWER SERVICE PERMIT
3795 Pilot Knob Rood 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:
Dote of Insp.: Total:
Insp.: Date Paid:
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Use BLUE or BLACK Ink
For Office Use 1
City of Eap I Permit I
3830 Pilot Knob Road ~ Permit Fee:
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 1 I
Fax: (651) 675-5694 1 Staff:
- - - - - - - - - - - - - - - - -
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: IL Site Address: 1 l I~ I Y Unit
Name: I I I l11 1 ! ~ ~ 1~ 1~ f 'C~ yl ; I I~Phone: ;t w~ I VU'
Resident/ '
Owner Address / City / Zip: Ell 2-
Applicant is: Owner Contractor
Description of work: ld V,~L~ " (A
Type of Work Q
Construction Cost: V Multi-Family Building: (Yes X / 'No . )
Company: 154 a QicccI yy1 C'_,n d &gied~~ ~n4 ntact: ''J? V
Contractor Address: t-h Q r )~L=PIs/0~ PJ(u~ City: , S4 Lock
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State:h 'Z`ip:~~ f° Phone:
License #:C~2 v01 U 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.aopherstateonecall.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 1 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.
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Applicant's Printed Name App ' is ig ature
Page 1 of 3
City of Eagan41' Permit Type: Plumbing
PERMIT
3830 Pilot Knob Rd Permit Number: EA141326
Eagan, MN 55122 • Date Issued: 03/07/2017
(651)675-5675 (� (j Permit Category: ePermit
www.ci.eagan.mn.us O Q Q
Site Address: 1521 Clemson Dr B
Lot: 9 Block: 03 Addition: Thomas Lake Heights
PID: 10-75950-03-090
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
Total: $60.00
Contractor: - Applicant - Owner:
Bonfe's Plumbing&Heating Mary L Doyle
505 Randolph Ave 1521 Clemson Dr B
St Paul MN 55102 Eagan MN 55121
(651)228-9071
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.
Applicant/Permitee: Signature Issued By: Signature