1618B Clemson Dr CITY OF EAGAN WATER SERVICE PERMIT
3830 Pilot Knob Road
P.O. Box 21199 PERMIT NO.:
Eagan, MN 55121 DATE:
Zoning: No. of Units:
Owner:
•
Address:
Site Addess: 71E'
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:
By / Date Paid:
Date of Insp.:; ; Insp.:
CITY OF EAGAN SEWER SERVICE PERMIT
3830 Piled Knob Road
P.O. Box 21199 PERMIT NO.:
Eagan, MN 55121 DATE:
Zoning: No. of Units:
Owner:
Address:
Site Address:
Plumber:
I agree to comply with the City of Eagan Connection Charge:
Ordinances. Account Deposit:
Permit Fee:
Surcharge:
By ° - Misc. Charges: _
Date of Insp.: Total:
Insp.: Date Paid:
i(0k$ 1(,168
C ,
_ ____I --1,_.. 0 ,
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Use BLUE or BLACK Ink
rti
For Office Use
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:*
_ u..
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
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from:Taylor Gabla Fax:(763)400-4503 To Fax: +1 (651i 675•5699 Pag<_ 1 of 2 0311812015 12:33 PM
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� RE5IDENTIA�
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----_L�wn Irrigatian(�,, f�f'2 f e,�PVB� '" '�, �
P�r�rtit Ty�pe r+,dd Piumbing�ix4atre_ I+il39n!„LQwer Lew�lj �
Septic.Systerm " `
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hleu1 Water Tum�roi�nct
`` ` ` Rbandanment
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; $60.Q0 Waler Heal.er,lNafer ao�te�er, pr INat�r Heater�nd�off�r;�r(inclucles�S:OQ 5ta�e Surchar�e)
; ._ ...
� $6U.Q4 La+��n Irrig�tinii(inrlucies�5:��minimum 5t�te Surcharg�)
� $6t3.Ui4�dd Pfumbing Fixtur�s,Septic 3Vstem l�bancta�merrl,Water Tur�around"(incfudo��S.Of�5t31e Surch�rg�}
� '�tt�aterTurn�r�,und{add�204,Q0 if a 5t8"meter is requir�d)
% �115.00 Septic Svst�m f�e4s+{S�Q:�O per as bu�IC)(in�lud�s County fee an�i SSAt�State SurGhar�e}
{ '1`Q3"fAL FEES S �-���� .�.�'C�:�
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CALL E3F�C',IF�E'I(C�l.! alCs. Ca#I Gopher State One Gall:at(85'I)454-(1002 for pro�er,.tian ag�ins�underground utitit:y d�r�ac�2.
Call 48 ho�+rs before yots�n6end it�dig to f�ceiv€(�3�a.t�s Q!tandk�[gFOUnd utilities, vnv!r�.�c��t�er�l�te��nea9l:arg
1 h�r�by�C.Siripwl;er�gc i�rai th's i[r[armaiion is corn�.�tele and acciie�:c::Ch:3t:h�:work w"sll be iri r.ui�ti�irriar�r„e wiEti fhe�I'ti:nanC�S at�d Gcscle�Af tPi�±City�f
Eagan; 4hat I unde+�stan�� il��s is not r� peemil, t�u1 onlW;�r�au�lti�ati�tt far��ern?it. ��d wnrk is noi tn,t1rt witEtioui a per¢nit; ihat the work will ts� in
acc�rdance wilh th�a�prov,wct plan 3n the case af wark vrhich rec}uires a rcv�ew�nd 2ppravaE of pfans.
it + 1�dl fL�'�,. T'�,����-�i 5�` x -
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A�plicant's Rrinte�i N'ame Ap�siican:t s 5ignalurs
_ __ .__
FOR OFfICE llSE F�erviev�e�l By. Date: °:
Requ�retl Ir�sp�cticar�s: ; Ur�der GrQCi�d Ra��i.gh-In A�ir'��st C�s Test. Final �
Meter.Related items:; P�9r ter Size .: F��tlit���ad Pular�c�met�r Sfatf;,
;
�
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA152339
Date Issued:10/10/2018
Permit Category:ePermit
Site Address: 1618 Clemson Dr B
Lot:11 Block: 01 Addition: The Trails Of Thomas Lake
PID:10-75865-01-110
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
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 -
Robert B Sorenson
1618 Clemson Dr Unit B
Eagan MN 55122--481
Dean's Professional Plumbing
7400 Kirkwood Court N
Maple Grove MN 55369
(763) 428-1321
Applicant/Permitee: Signature Issued By: Signature