1587 Clemson Dr CITY oF.EM3A g WATER SERVICE PERMIT
3830 -Pilot Knob Road
P. O. Box 21199 PERMIT NO.:
Eagan, MN 55121 DATE:
Zoning:
No. of Units:
Owner:
Address:
Site Address:
Plumber:
Meter No.: Connection Charge:
Size: Account Deposit: No.: posit:
Permit Fee:
agree to comply with the City of Eagan Surcharge:
Ordinances, Misc. Charges:
Total:
By �
Date Paid:
Date of Insp.: Z,27,3V In
CITY OF.EAGAN
3 83(?Pilot Knob Road SEWER SERVICE PERMIT
P. O. Box 21199
Eagan, MN 55121 PERMIT NO.:
Zoning: DATE:
Owner: No. of Units: '
Address:
Site Address: T '
Plumber:
!agree to comply with fie City of Lagoa Connection
Charge:
Account Deposit:
Permit Fee:
By Surcharge:
Date of i
Misc. Charges:
I asp.: Total:
Dot Poid:
9
Use BLUE or BLACK Ink
I For Office Use
~q of Eap I j Permit _AVOIq 4 j
Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 Date Received: JA, 13
_Va Phone: (651) 675-5675
i I
Fax: (651) 675-5694 1 Staff:
I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION #
Date: Site Address: L6154) $ $ 0192, AC_6m~5- un~
Name:I AIrf-2 Z__~ tl T&WL/S_-- Phone:
Resident
Owner Address / City i Zip: -
Applicant is: Owner - Contractor
Type of W*rk Description of work: Remo e-r1 - - -
Construction Cost: 80 Multi-Family Building: (Yes / No
Company: rT Contact: '3:~_L~Gq EMI)
Contractor Address: O I"I ti eh~~?k-----city: 1~/_/?_n,°Q/i-S
State: Zip: Syd ~ Phone: 612 i-~~ ~
License 2e - 19106 2- Lead Certificate #:_&A - 2
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: flans 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 the are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Cali at (651) 434.0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. MM.gonhen tateonecali.ora
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 Cade must be completed within 180
days of permit issuance.
X. fi 2a.bP_ 46~n rd! en x
Applicants Printed Name 1 Applica s Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA131220
Date Issued:06/09/2015
Permit Category:ePermit
Site Address: 1587 Clemson Dr
Lot:51 Block: 02 Addition: Thomas Lake Heights 2nd
PID:10-75951-02-510
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)$55.00 0801.4087
Surcharge-Fixed $5.00 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 -
Muriel A Failor Tste
1587 Clemson Dr
Eagan MN 55122--481
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature