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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 , y6- 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 .n from:Taylor Gabla Fax:(763)400-4503 To Fax: +1 (651i 675•5699 Pag<_ 1 of 2 0311812015 12:33 PM 4Jse BLUE ar BLA,GK!nk ---------------� yOFat{}i'ii�ce t3se ! ' �`��� � E .� � �' � I fSGr��.i4%r':�...m.� ; �'y � �....��_�� �. ���� �� ����.ii � Fc�irdCFe�� I 383Q Pi1�fi Knob Road i , / � E�g�n M3'� 55122 i f)�lc Receiv�C:_ '1 .� � Pl��ne; (�i�`�) G75-S67'S � st�r�f: ..� i � � Fax: (651y fi75-S634 ------------------. ���51'�E�I[?�B�TII�:L F'L�l�BI�lG �E��IT ���L1��TI!Oh� J � ta .q.�, y [1at0: f_ �� ����� .�"il�&3{kdi)r2SS: �trr ��f� k.� �,ti�``"�ir�a�.e�� �rT i :r "�y ,„ Tenar�t:,.�.,��°�`..i(� �t,� ��t`�.t��%6'�d S�uife#, ' ; , > N�n�e: � �1"it�f.�:� .?fx�l��.t'�"�,i;�`'� _ _ �hone: Resirientl4wne�- , ' ' Add���s;c�cx.i z��: � �k`� ��� �;w�rV+.��`�'1 ,.�. ..�.,�.�. _� �.___.� . .�_.,�.�.... n.-_ .. ,.. .,._.�. � [ ( ry,�� i Narne: �.��f?�.��", ��Y t�"1 Y���,�V'��Y�'��"�G�_ _ucense#fi: _._ 1 Gontract+ar.. adar�ss �����ti�' ����'�1,�.;� ��;� �.,5 ��y C��y: �w�h�,'`( , 1 � f �" I- "21 � t + Stat�:: _�`4��+_ 2�p: ,�'}�,,:�,.�'�� _ - Phane� �� z1 ��� :S -. �I [ I . � i k.: ; ' �ontact: ���'v��� �'. �mai�� ��4����L� ��i�',�.)`1�.��'t '71�'El�� f�:'I�t�l � £.,_,.__�_,_.. � _.�........�.,�.m.-- __�..�.r..�....mm,_�..,�,.�,_ ---�- .�.. ._._._��.._...�.,....__� .._. -------- .��._ ' ' ` _�New +�F�e�lace�►�i�nt _,..._Rep�ir _.Rebuild _P,�c�c#i(y Space ,,,,_,_„4Vor3�in fi.0.�h1. � � ! Ty�pe.af Wark ( [Jiescriptian of wor.k: .�_.�_..,�,.....,.�,.......,._...�_ �.-,-.�_.�,��.,.., �oo,..�...� _ — --= .,...,.., _.._.._ _.. . _ � RE5IDENTIA� �U�laier Heatet � �l4'�te�Sofien+�r { ----_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 " ` ' ' ..�.__ hleu1 Water Tum�roi�nct `` ` ` Rbandanment . ,. jwT_.._._........ '�..�,�� ��..�.�..�.�..w...e... __ -....,.. _ .....e—...--.—...-.,..:..^..._,..�.::....�_ �.....�.��,._._..,..........:.........,�....,........_. ..._..._ ___ _...._._._.....�.,,_........�.Y..�.�.�......_.._.....E, � �ES�o�r�ria�F��s: __ ! , _ . _. _ ; $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�:� r 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 - �'��.. 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