1618 Clemson Dr WATER SERVICE PERMIT
3830 Pilot Knob Road PERMIT NO.:
P.O. !lox 2 i 1y9
Eagan, MN 55121
Zoning: — No. of Units:
Owner:
Address:
Site Addess:
Plumber: r ,
Meter No.: — Connection Charge: -
Account Deposit:
Size:
Permit No.: ermit Fee:
I agree to comply with the City of Eagan Surcharge:
Ordinances. Misc. Charges:
Total:
Date Paid:
By
Date of Insp.: ♦ .� Insp.:
•
•
CITY OF EAGAN SEWER SERVICE PERMIT
3830 Pilot Knob Road PERMIT NO.:
Eagan, Box MN 55121 DATE:
Eag MN 55121 No. of Units:
Zoning:
Owner:
Address:
Site Address:
Plumber:
I 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:
Insp.:
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Permit
r City of Ea~~ii a~
~ Permit Fee: ~
3830 Pilot Knob Road I ((3 1
Eagan MN 55122 l Date Received:
Phone: (651) 675-5675 1 I
Fax: (651) 675-5694 1 Staff: I
I I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: adl~l Site Address: M 9QK, 6 Unit
-
Name: l ~/ttl5 t!f l AO/h~ S ( -GJ r L2 Phone: 7q 7 7 511
t Resident/
Owner Address / City / Zip: #C3z),re
I Applicant is: Owner Contractor
Type of Work Description of work: 14Y 'F- r e D'
Construction _Cost JUlulti F
Company: ~ Contact:
q3q: {~G_ 6n in ,e. N ► ~1 L alto
Contractor i Address: City:
i State: Zip: Phone:*
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ea~ eCerti ief'W.- _
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
(lV o Af)ZA, bet-'o 0
i 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:
I NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information maybe 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 Cali at (651) 454-0002 for protection against underground utility damage. Cali 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 tate Building Code must be completed within 180
days of permit issuance.
X t)(1~i V'VIe-S- x
Applicant's Printed Name Ap 'cant's Signature
Page 1 of 3
.n
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA131372
Date Issued:06/17/2015
Permit Category:ePermit
Site Address: 1618 Clemson Dr
Lot:12 Block: 01 Addition: The Trails Of Thomas Lake
PID:10-75865-01-120
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:One Window/Door
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 500.00
Fee Summary:BL - Base Fee $500 $40.00 0801.4085
Surcharge - Based on Valuation $500 $0.50 9001.2195
$40.50 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 -
Mary Y Talbot
1618 Clemson Dr
Eagan MN 55122
(651) 249-3220
Crew2 Inc
2650 Minnehaha Ave
Suite 100
Minneapolis MN 55406
(612) 276-1680
Applicant/Permitee: Signature Issued By: Signature