Loading...
3879 Dolomite Dr CITY OF EAGAN WATER SERVICE PERMIT 3795 Mot Knob Road PERMIT NO.: Cagan, MN 55122 DATE: Zoning: No. of Units: Owner: — -- — — Address: Site Address: Plumber: - Meter No.: __ Connection Charge: Size: Account Deposit: Reader No.• Permit Fee: agree to comply with the City of Eagan Surcharge: Ordinances. Misc. Charges: Total: By Date Paid: gate Insp.: Insp.: CITY ,OF EAGAN SEWER SERVICE PERMIT 3795 Pilot Knob Road •Eagan, MN 55122 PERMIT NO.: DATE: Zoning: Owner: No. of Units: Address: Site Address: -- Plumber: agree to comply with the City of Ea an 1,_ g Connection Charge: ° Ordinances. Account Deposit: Permit Fee: By Surcharge: Dote Misc. Charges: ote of Ins p.: I Total: nsp.: Date Paid: Use BLUE or BLACK Ink I For Of es Use I City 0l E~ ~ PennitiR nil I Permit Foe: ) `J I 3830 Pilot Knob Road I I Eagan MN 65122 Date Received: j Phone: (651) 675S6T5 I I Fax: (651) 675-5694 1 Staff: I I I 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 9-~7'" Site Address: 3$77 94 Ti, R:3 -unit Name: d o A C '7 /,V)4 ..S 4 G Z M 1, u -X A-' C Phone: 7GA --f3-9';70 vll ler " Address/ City /Zip- TS ~ ID 4,01 7"u,e 4V A3 r2 p Goia E.y /r~ 5ry'x 7 Applicant Is: Owner X- Contractor TYRe;ai'm4rk Description of work: `T £~9,2 © a 2 E - r . Construction Cost 43 7 aU - CAD Multi-Family Building: (Yes I No. ) Company: 616 1 ~x7e.2~o,Q Aflh, 17 . 6aP Contact -bAv),& %O t- R 15 Address: yo 6 V "'L ST City: /h PZ. s . . , Phone: s te: NAJ Zip: License 4 C Lead Cerdflcate If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) L3&ar- 460 1 L91 POs, J F7 7 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: INOTE'.;R( pnrld g I. M Try ~ '1 3 ".A' ro~v. ~:,/1c!i•',~.7Y,',. I '!T , ` ~ 1+"!"~i,_' P. f11.PlF~...' .M~}~'F'~ . '.I.. ~'Po'Vi .~~IYii.'.~. ~SyA 11"~'4Y;: 1'r,' f~,4 ~.,c.r.... CALL BEFORI= YOU DIG, Call Gopher State One Call at (681) 464-0002 for protection against underground utility damage. Call 48 hours before you Intend to dig to receive locates of underground utilities, www.aooherstateonecall.oM I hereby acknowledge that this information is complete and accurate; that the worts 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 mccoroance with the approved plan in the case of work which requirse a review and approval of plans. Exterior work auBtori¢ed by a building permit Issued In accordance with the Mlnnesota State Bulldin Coda must be completed within 180 days of permit issuance. x bA✓!ts %um, /S X Applicant's Printed Name Applicant's Signature Page 1 of 3 60/Z0 39Cd iNIVW 1X3 I3a L9Z9Z98ZI9 05:bi 6Z0Z/bZ/60 Use BLUE or BLACK Ink _ I For Office use ' aC~1 My of Ealn ~ t~enmit& I I vJ I Permit Fee: 3830 Pilot Knob Road j 1 Eagan MN 56122 I Date Recelwd: Phone: (661) 67545675 $taf~ 1 Fax: (651)675~6684 i I . 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: •x SkeAddimes:37-77, 3T79, 39S1, 3V83 t~vr►~~ Unit* Name: o% 4 6 ~i R*4 4 b -F,"( L A3 T w C. Phone: 7!0 3- rF 3- 9 7 7,0 Re$ident/ Ovinfer Address / City / Zip: *-TO Q Z c W -u R A IV, 64146f-,J A 1 Y IWA) J4r 4`17 Applicant is: Owner ,KComc for TY0'01,wi" k, 17ee0ip00n Of work f'Sw-e 1F- P::E PG 4-e-£.. L~ .+J ~1 b 1 ,6~ a 14 S r,S L Construction Cost I y Q4o• cro Muni-Family Building: (Yes,/ No Company: E 1 6e r- t e~ o 2 /"ih Aj"'r' . Cn RA Contact b4 ✓ r Address: ~/n s' (~1 looms -07', City: /y! PG S Craotar State: !'r1 Zip: Phone: Z • Y to ~ - to x V-3 License C- x Y/ / 3 ! Lead Cortlflcatie If the proj0d is exempt from lead certification, please explain why: (see Page 3 for additional information) gL4&S_ Q~rL7 Post' ~5~~ COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 morift, has the City of Eagan Issued • permit for a similar plan based on a masbr plan? -Yes No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical ContracWr. Phone: Seviter & water Conbvztor. Phone: CAI I I`FO Y DI Call Gopher Sble One Ctdl at (fist) 45"M for proteCtlon epairot underproun0 Wllgr damage Cell 48 hours are you listen to dig to mw Iv* locates of underground utllWa& www;,oohenxamoneeall.ora I hmby acknowledge that this irlfolmaGon is COW1019 and accurate; that the worts will be in conforinv= with the ordinances and codes of the City of Eagan: that I understand thfa Is not a Penh, but only &n aPPlioation for a permit, and wont is not to start wlUiOtd a pemnIt: that to work Will be in aocorttance with the approved plan in the case of work which requires a review and approval of Weans, Exeerior work authorkod by s building pemut issued in accordt toe with die Minnesota Stela Buft Code must be oompMeed within 180 days of permit ftsuence. X ~afr~O ~d~2-/L/S ApplicAnra Prlnbd Name x Applicants Signature Page 1 of 8 b0/b0 39Cd 1NIVW 1X3 I3S L9Z9T98ZT9 0Z:t7T bT0Z/6T/Z0 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA162799 Date Issued:07/29/2020 Permit Category:ePermit Site Address: 3879 Dolomite Dr Lot:14 Block: 01 Addition: Briar Hill 3rd PID:10-14992-01-140 Use: Description: Sub Type:Residential Work Type:Replace Description:Standard Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087 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 - Sarah Miller 3879 Dolomite Dr Eagan MN 55122 (651) 402-6172 One Hour Heating & Air 11825 Point Douglas Rd S Hastings MN 55033 (651) 437-4177 Applicant/Permitee: Signature Issued By: Signature