3254 Dodd Lane VILLAGE OF EAGAN WATER SERVICE PERMIT
3795 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:
I agree to comply with the Village of Eogan Surcharge:
Ordinances. Misc. Charges:
Total:
By Date Paid:
Date of Insp.: Insp.:
VILLAGE OF EAGAN SEWER SERVICE PERMIT
3795 Pilot Knob Road PERMIT NO.:
Eagan, MN 55122 DATE:
Zoning: No. of Units:
Owner:
Address:
Site Address:
Plumber:
I agree to comply with the Village of Eagan Connection Charge:
Ordinances. Account Deposit:
Permit Fee:
Surcharge:
By: Misc. Charges:
Date of Insp.: Total:
Insp.: Date Paid:
Use BLUE or BLACK Ink
j For Office Use 1
Iz~~ ►~1
City of Eajan ; Permit
Permit Fee: I
3830 Pilot Knob Road l I
Eagan MN 55122 Date Received: 1
l 1
Phone: (651) 675-5675 ; Staff: ;
Fax: (651) 675-5694
2014 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: site Address: 325' W~ LeL~'= sy/ Z l
Tenant: Suite
Resident/Owner Name: )I 0_U LL) e- e!1 ~e_L~ Phone: ~,~I -33-5--
Address l City 1 Zip:_52-~_q D J_znr_ cp ST-121'
Name: License
Contractor Address: City:
State: Zip: Phone:
Contact: Email:
Type of Work - New Replacement _ Repair _ Rebuild - Modify Space Work in R.O.W.
Description of work: !uL" t54fl✓~ _VcL'l'(. Ec~ L.)j Th T6klti(
RESIDENTIAL
J Water Heater
Lawn Irrigation RPZ / _ PVB) Water Softener
Permit Type Septic System Add Plumbing Fixtures Main Lower Level)
New Water Turnaround
Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$60.00 Lawn Irrigation (includes $5.00 minimum State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
*Water Turnaround (add $200.00 if a 518" meter is required)
$115.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
TOTAL FEES $ b
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.go2herstateonecall.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.
x n x
Applicant' Printed Name Appl n s Signature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Rough-In Air Test Gas Test Final
Meter Related Items: Meter Size Radio Read Staff:
Use BLUE or BLACK Ink
I For Office Use
I j I
City of Eap Permit#. I Permit Fee: v J
3830 Pilot Knob Road
Eagan MN 55122 j Date Received:
Phone: (651) 675.5675 1 1
Fax: (651) 675-5694 I Staff: I
I I
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 19 - I I Site Address: M L Unit
Name: -3a Phone:157 -33-5--2xtl
Resident/ 2 cam, / /
Owner Address /City / Zip; Li macaw r.J1 A
Applicant is: Zomer Contractor
I_ reDlar-P -W .1 'D s L) -SWMe S) 72 P1 6I
Type of Work Description of work: 1
Construction Cost: J gn- Ia ~S Multi-Family Building: (Yes No )
Company: Contact:
Contractor Address: City:
State: Zip: Phone: Email
License Lead Certificate
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 the 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.oooherstateonecall.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 Code must be completed within 180
days of permit issuance.
Lo eiA~(Z A6~ x
Applicants Printed Name App a s Signature
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