1530B Clemson Dr CITY OF EAGAN WATER SERVICE PERMIT
3705 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:
/ /) Total:
By � 1 1 Date Paid:
Date of Insp.: Insp.:
CITY OF OF EAGAN
3795 Knob Rood SE WER SERVICE PERMIT
PERMIT
NO.:
Eagan, MN 55122
Zoning: DATE:
Owner: No. of Units:
Address:
Site Address: �� _
Plumber:
1 agree to comply with the City
Ordinances, °t Eagan Connection
Charge;
Account Dep osit:
Permit Fee:
By Surcharge:
Date Misc. Char
ges:
ate of Insp.:
Insp.: Total:
Date Paid:
Use BLUE or BLACK Ink
I For Office Use I
j Permit 112D
City of Eakan
I Permit Fee: a57.1 I
3830 Pilot Knob Road 1 S
Eagan MN 55122 j Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 1 Staff- I
I I
2013 RESIDENTIAL BUILDING
/jP ER~/M~ IT APPLICATION
Date: Aul Site Address: f~) ~ e~~ 1 ~~ov 1 V Z Unit
Name: I ~ of iV l Phone: 0 ~i`( ~ W' ~
Resident/ -
Owner Address / City / Zip:
Applicant is: Owner Contrac or
Type of Work Description of work: Vt/(}t t 1 ~,~I ( Uih6 rLMUMA (A0,VAW 1 gal `'~p. (r
J
Construction Cost: ' /a V' O V Multi-Family Building: (Yes X / No )
Company: 8eLLL (1t t' i I d,,JQeMCCJe_[ nG `t.o tact:
Contractor Address: C/IbD 2_:iUslOv- bike d city: vtpis iL
State: Zip: ~ 5U I U' Phone: IEQL-
License O 'D U ~ Lead Certificate P~ ` ' s~' 3 J
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:
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.gopherstateonecall.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 OiAAA'Th S Po-A 1~ n~v__~
Applicant's Printed Name App ' is ig ature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA155347
Date Issued:05/13/2019
Permit Category:ePermit
Site Address: 1530 Clemson Dr B
Lot:11 Block: 02 Addition: Thomas Lake Heights
PID:10-75950-02-110
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.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
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 -
Gabrielle A Dabu
1530 Clemson Dr B
Eagan MN 55122
(612) 214-1904
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature