1525 Clemson Dr CI 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:
I agree to comply with the City of Eagan Surcharge:
Ordinances. Misc. Charges: -
Total:
B . ■Date Paid:
Date of Insp.: / j7// �� Insp.:
- CITY OF EAGAN SEWER SERVICE PERMIT
3795 Pilot Knob Road 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:
Date of Insp.• Total:
Insp.: Dote Paid:
Use BLUE or BLACK Ink
------Use-----------
~ For Office I Permit 10 1 Ito
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City of Eakan
I Permit Fee: ~ `i • ~ 6L
'
3830 Pilot Knob Road
Eagan MN 55122 Date Received: ~~l l3 j
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 1 Staff: I
I I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date:// / J 5 S / /i 5~ v
Site Address: Unit
Name: ~6'Yl.ci Q CG b~Y -e v u n Er'S Phone:&/a ` 7C3d 7~.
Resident/ _ ~
Owner Address / City / Zip: ~5a 3l / n o d /ernS&k? kJf'
Applicant is: Owner J` Contractor
ctr n
Description of work: -r' C3C Q /~c~ rQ/~%~~ 5,
Type of Work
Construction Cost: 5 O Multi-Family Building: (Yes No
)
Company: 15'e-1 TlOQC1 VI C_n J Q eiTV_ J I rn4 tact:
Contractor Address: q)OD IUISIOY-- PJ(Ud -city:, S4. L(-)LL
State: h Zip:~~ 1'~' Phone: Q- - 07 l S ° la 22
License 6- fLoo) CU B Lead Certificate ~A 0 G6 3 4 - i
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:
Re
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.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 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 of permit issuance.
x ~I zi1 /trc . l.{ fl~C x
Applicant's Printed Name Applicant' Signature
Page 1 of 3
DO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation _ Fireplace _ Porch (3-Season) - Storm Damage
Single Family _ Garage _ Porch (4-Season) - Exterior Alteration (Single Family)
Multi _ Deck _ Porch (Screen/Gazebo/Pergola) - Exterior Alteration (Multi)
_ 01 of Plex _ Lower Level _ Pool _ Miscellaneous
Accessory Building
WORK TYPES
New _ Interior Improvement _ Siding _ Demolish Building*
Addition _ Move Building _ Reroof _ Demolish Interior
_ Alteration _ Fire Repair _ Windows _ Demolish Foundation
Replace _ Repair _ Egress Window _ Water Damage
Retaining Wall *Demolition of entire building - give PCA handout to applicant
DESCRIPTION
Valuation Occupancy MCES System
Plan Review Code Edition SAC Units
(25%_ 100%___) Zoning City Water
Census Code Stories Booster Pump
# of Units Square Feet PRV
# of Buildings Length Fire Sprinklers
Type of Construction Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final / C.O. Required
Footings (Addition) Final / No C.O. Required
Foundation HVAC _ Gas Service Test Gas Line Air Test
Drain Tile Other:
Roof: -Ice & Water -Final Pool: -Footings Air/Gas Tests -Final
Framing Siding: -Stucco Lath -Stone Lath -Brick
Fireplace: -Rough In Air Test -Final Windows
Insulation Retaining Wall: _ Footings _ Backfill _ Final
Sheathing Radon Control
Sheetrock Erosion Control
Reviewed By: , Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
15 23 11~ 2~ I 15 as P I OZ_ '8 C w wt son W
Use BLUE or BLACK Ink
F-----------------
For Office Use I
I I
j Permit 113Q 8 11 j
City of tap Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 1 Staff: I
I I
2013 RESIDENTIAL BUILDING
/~PE~}RI/
Date: Site M~ IT A~P` lPL~ jIC V t ATION
~e~} f!\~ El y J y iI Unit#•
"je Y I o Address:
S'A~dd t j~ ~ j ~ ,fit
wj~ t~ ~ 4 a ` . i a i l V Phone: 19' s M G C
Name: 1
Resident! - ~ - ` , '
2
Owner Address / City / Zip:
JC
i
Applicant is: Owner Contractor
Type of Work Description of work: ~ 11 W4 CAffAA Limului CAI - 91& m Nf
Construction Cost: V Multi-Family Building: (Yes X / No )
Company: LL f1occ IY)0) a-A't Q2"_d(d rnJ `Eontact: ~&Uwt yr `V 1
Address: CI )()G f ,~C11~SIC~v- 6%Jd City: _S4 LC3u-
Contractor
State: MV Zip: S~y Phone:
License 0-1Q_0D LU 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.cioi)herstateonecall.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 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 of permit issuance.
X [/l 4 Po'A.Miv-,'~
Applicant's Printed Name App ' 1Vs ig ature
Page 1 of 3
Use BLUE or BLACK Ink
r-----------------�
� I For Office Use �
�� � Permit#: � � �
��J O� ����� I P rmi F : � �� �
e t ee
3830 Pilot Knob Road /
Eagan MN 55122 RECEIVED � Date Received:/ ' �o✓��
Phone: (651)675-5675 I I
Fax:(651)675-5694 OCT 2 O Z015 i Staff: I�
-----------------�
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2015 RESIDENTIAL BUILDING PERMIT APPLICATION C .a�'r�
(� �� �1
Date: ��(� ��' ��J' Site Address: �`� �� ����Jl '� � L � �
� : � G�� '"t v �� '� Unit#: ��
����
���'����"��� �;, _�„i � - 7
� Name:��c ..�.� 1 G �-� � ��7rJ �%� Z
° � c ��--�.v`'�� �'� Phone:
�R@Slt���� c
OW.t1�:�. Address/City/Zip: ���5 � �L,sv�.�G� �� [��i�"'{ vt /L�..✓l�
�. , /
°�,. .. Applicant is: Owner t/ Contractor
� :t
#� �� ��� Description of work: � ��;.�� ���'(,cs�
����Of al�l��c` ,
� � ' Construction Cost: � ����'�, --� Multi-Family Building:(Yes /No )
� � �Company: .(' -� �� � w- �--�--- Contact:
�#::
�� Address:��. �.. � ��V City: �i�v � ��t`J(
�� ��Mtt'a�#��'
� .__ � /���,�,� / 1
State:�Zip:;j��'`� Phone: � � � ,S� Email: ��;FJ�`l°'�Sc�l��ci'�� "TS,,zn�:� ,•c c�.�.�
'`} y�� ;; ,
1
�� License#:���C��3'7 t-��� � Lead Certificate#:
If the project is exempt from lead certification, please explain why:
'(�'�-. c�.- ,
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 8 Water Contractor: Phone:
Fire Suppression Contractor: Phone:
NOTE �fans a�su���#in d # # � ` Y � �
9 +�i�i�� �ts�h�� o�su�m�t�a�'������� �� ��c�n � �f
� � � � � � � # : �� � � n � � ��
r:�tl���nform��i�cn��,y�te cl����#'i�d as r����pul�l�c r���i�prc�i�ii��sp����c�������'�at wor�ltl.p� ity�#b��'�
��, cori����'�e that,tla� ,�re:tra�le,���r���°��,�;���j€��� n,;zs ��a �... �
M �:�
v...., x... �� . �. ..:�..#��
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)4540002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.qopherstateonecall.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 of permit issuance. ^
x X • ��_'°
Applicant's Printed Name App ica s ignature;''
' Page 1 of 3
DO NOT WRITE BELOW THIS LINE '��
SUB TYPES � . �.'�k1^'1�"`� �r �
_ Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration (Single Family)
� Singie Family _ Garage _ Porch (4-Season) _ Exterior Alteration (Multi)
_ Multi _ Deck _ Porch (Screen/Gazebo/Pergola) _ Miscellaneous
_ 01 of_Plex _ Lower Level _ Pool _ Accessory Building
WORK TYPES
_ New � Interior Improvement _ Siding _ Demolish Building*
_ Addition _ Move Building _ Reroof _ Demolish Interior
_ Alteration Fire Repair _ Windows _ Demolish Foundation
_ Replace _ Repair _ Egress Window _ Water Damage
Retaining Wall "Demolition of entire building-give PCA handout to applicant
DESCRIPTION
Valuation �12� �`� �'�� Occupancy �.- lz�" �j MCES System
Plan Review Code Edition ��'�� �c%�-j� SAC Units
(25%_100°/�) Zoning � City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction --�� Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final/C.O. Required
Footings (Addition) Final/No C.O. Required
Foundation � HVAC_Gas Service Test Gas Line Air Test
Roof: _Ice &Water _Final Pool: _Footings _Air/Gas Tests _Final
� Framing Drain Tile
Fireplace: _Rough In _Air Test _Final Siding: _Stucco Lath _Stone Lath _Brick
� Insulation Windows
Sheathing Retaining Watl: _Footings_Backfill_Final
Sheetrock Radon Control
Fire Walls Fire Suppression: _Rough In_Final
Braced Walls Erosion Control
Other:
Reviewed By: � �cM ►�1�� �j�f� , Building Inspector
RESIDENTIAL FEES �`�1- �.��i2��'°� `f�-� �� ��� �
Base Fee
Surcharge �1 f Ctir�✓� �- y��h�E�`'v�� S L� sq • ��
Plan Review
MCES SAC � .z `� � b�' S � y�� '
City SAC
Utility Connection Charge
S8�W Permit 8�Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
Use BLUE or BLACK Ink
r-----------------
I For Office Use �
� � I
C�� O� � Permit#: � ��� I
y ���aIl �
, !_D�;� �
� Permit Fee: <••� �
3830 Pilot Knob Road
I �
Date Received:
Eagan MN 55122 j i
Phone: (651) 675-5675 j Statt: i
Fax: (651) 675-5694 �_________________�
2015 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: r0 "�� " �� Site Address: ���-5 C/Pl�t�t'"l� [��–��v�
Tenant: Suite#:
itesiden#�!��uner ,` Name: Pnone:
' Address/City/Zip:
e Name: ���V�Y ��(Jr'f�1�lt?u�►..Zll� License#: D 6 7 y�/
� C4ntractflr �� �� address: l�6 �9' /,6 6 � S� �/ c�ty: �c'a!�� v��//.e
�� State: M� Zip: .�,J���C( Phone:��,5`c7� 3q..S��,��7e�
Contact: ��' � Email: s�*'�'�G�ju"t�r'`'`� � ��'F'o ' �ou'' i'
T�/�e O��fl1'k —New _Replacement �Repair _Rebuild _Modify Space _Work in R.O.W.
Description ofwork: ��-S�t" � t�i�Q�S �a.��t �-� Cc`fC.fGoarS��� ,� La �ies
' RESIDENTIAL
Water Heater
Water Softener
Lawn Irrigation(_RPZ/_PVB)
P��������� "��� Add Plumbing Fixtures�Main/_Lower Level)
Septic System
New Water Turnaround
Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener(includes State Surcharge)
$60.00 Lawn Irrigation(includes State Surcharge)
$60.00 Add Plumbing Fixtures, Septic Svstem Abandonment, Water Turnaround"(includes State Surcharge)
'"Water Turnaround(add$210.00 if a 5/8"meter is required)
$115.00 Septic SVstem New(includes County fee and State Surcharge)
TOTAL FEES$
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage.
CaII 48 hours before you intend to dig to receive locates of underground utilities. www.qopherstateonecall.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 wilf be in
accordance with th a r v plan in the case of work which requires a review and approval of plan
____-_._...,___ _ .., _
X �R�C-�j �'�tY�ov
pp i anYs Printed Name App nt's Signature
��R OFFIC�llSE Reviewed Sy: 'Date:
Required lnspections: Under Groun�l Rough-1n Air Tes# Gas.Test F9na1
Meter Related Items: Meter Size `ftadio Read 1�lanomet�r Staff:
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA176764
Date Issued:05/31/2022
Permit Category:ePermit
Site Address: 1525 Clemson Dr
Lot:12 Block: 03 Addition: Thomas Lake Heights
PID:10-75950-03-120
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 -
Caitlin Ogawa
1525 Clemson Dr
Eagan MN 55122
Genz Ryan Plumbing & Heating
2200 West Highway 13
Burnsville MN 55337
(952) 767-1000
Applicant/Permitee: Signature Issued By: Signature