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1377 Easter LaneVILLAGE 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• VILLAGE OF EAGAN WATER SERVICE PERMIT 2195 Pilaf Knob Road PERMIT NO.: Eagan, MN 55122 Zoning: DATE: Owner: No. of Units: Address: Site Address: Plumber: Meter No.: Size: Connection Charge: Account Deposit: Reader No.: Permit Fee: I agree to comply with the Village of Eagan Surcharge: Ordinances. Misc. Charges: By Total: Date of Insp.: 1•s n Date Paid: Insp.: 411,11 C!tyofEaan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 r Use BLUE or BLACK Ink For Office Use �( Permit #: 110 tJ —57`� Date Received: 1 l'31>-12— Permit '3)12 Permit Fee: Staff: INFLOW & INFILTRATION PERMIT APPLICATION - Plumbing / Sewer & Water ` )377 64sy t_ 44-Aic. Date: �g' ` ,� � �� Site Address: Tenant: Suite #: &5-/ to Cf 3 -0747 Name: 5eCTT 1 }L Et�f;(S`C. Phone: CPS -7 — 6(1'3 - 6767 Address/City/Zip: 1 77 biSTN/2. u4Aie SLIvA16 /1411/• 5S-1 �3 Name: License #: Address: City: State: Zip: Phone: Contact: Email: PLUMBING (Within the building envelope) t Sump Pump Repair Other: Description of work: SEWER & WATER (Outside the building envelope) Repair Other: AeA - -444,144.p i,61Bay FEES $60.00 / Each (includes $5.00 State Surcharge) TOTAL FEE $ *Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit I/I repair costs for reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors can be found by visiting www.citvofeaqan.com/inflow, or City Hall at 3830 Pilot Knob Rd. 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.qopherstateonecall.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. Sear,- A- FfeeUa ec Applicant's Printed Name Applicant's Signature City of Eagan PERMIT City of Eaan Permit Type: Building Permit Number: EA119220 Date Issued: 11/19/2013 Permit Category: ePermit Site Address: 1377 Easter Lane Lot: 2 Block: 1 Addition: Wilderness Run 5th PID: 10-84354-01-020 Use: Description: Sub Type: Siding Work Type: Replace Description: Census Code: 434 - Zoning: Square Feet: 0 Construction Type: Occupancy: Comments: Please leave printed pictures of house wrap on site for the final inspection. When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to ensure maximum ventilation to attic. Call for final inspection after installation. Fee Summary: Valuation: 4,000.00 BL - Base Fee $4K $103.25 Surcharge - Based on Valuation $4K $2.00 0801.4085 9001.2195 Total: $105.25 Contractor: Csc Exteriors 8444 Pillsbury Ave S Bloomington MN 55420 (612) 767-6301 - Applicant - Owner: Scott A Hengel 1375 Easter Lane Eagan MN 55123 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. Applicant/Permitee: Signature Issued By: Signature