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1527B Clemson Dr CITY OF EAGAN WATER SERVICE PERMIT PERMIT NO.: 3795 Pilot Knob Road PERM Eagan,' MN 55122 _ No. of Units: Zoning: — Owner: Address: Site Address: Plumber: Connection Charge: Meter No.: Account Deposit: - - -- Size: - - -- Permit Fee: Reader No.: Surcharge: agree to comply with the City of Eagan Misc. Charges: Ordinances. Total: c Date Paid: Date of Insp. Air , .// 1nsp.: 3a D: SEWER SERVICE PERMIT CITY OF EAGAN PERMIT NO.: 3795 Pilot Knob Road DATE: _— .- - - - - -- Eagan, iMN 55122 No. of Units: Zoning: Owner: - -- -- - - -- —_ Address: Site Address: -- Plumber: 1 agree to comply with the City of Eagan Connection Charge: Account Deposit: Ordinances. Permit Fee: Surcharge: ___ Misc. Charges: By _Total: Date of Insp.: Date Paid: I nsp.: 15a~ Ar.15a~ tayUse BLUE or BLACK Ink I For Office Use I I p I j Permit#: 1 City of Eakan I 5 . ~s Permit Fee: 1 3830 Pilot Knob Road p Eagan MN 55122 j Date Received: lot i ~5 I Phone: (651) 675-5675 I 1 Fax: (651) 675-5694 1 Staff. I I I - - - - - - - - - - - - - - 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: C~ e f f f\ ~/Vy i f V Unit Name: -n' I tJI I l U ~ ~ it r Je , ~ J , l l~ Phone: , G':< S _ Resident/ ` V~ /Vu 3-4& Owner Address / City / Zip: 2 2 r Applicant is: Owner} Contractor A Type of Work Description of work: V V o (kwl vVtn G c t Construction Cost: V Multi-Family Building: (Yes / No ) Company: 0- Qit inel Ca qd QE?`'r1ed ItAi `tt o)htact: ' l'i-A124til 1 Contractor Address: Cf)(-) G >L~ols/O v- Q%jd City: _S4. Lo LL State:h 'Zip: Phone: ESQ License ~IC> ] CU 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.oor)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. 12 ~ 71A d T-h 1 10 S~ XP Applicant's Printed Name App ' is ig ature Page 1 of 3 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA172964 Date Issued:10/22/2021 Permit Category:ePermit Site Address: 1527 Clemson Dr B Lot:14 Block: 03 Addition: Thomas Lake Heights PID:10-75950-03-140 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 - Lisa Knoof 1527 Clemson Dr Unit B Eagan MN 55122 (651) 226-4954 Warner Stellian Co Inc 550 Atwater Circle St Paul MN 55103 (651) 222-0011 Applicant/Permitee: Signature Issued By: Signature