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3762 Golden Hill Ter
VILLAGE OF EAGAN WATER SERVICE PERMIT 3795 Mot 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 Eagan Surcharge: Ordinances. Misc. Charges: Total: B 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: 3 bb, 31 to a, 37 c~ 4, 3 b co 3~ f~ $ l 3~~ a (210 d6 QM Wlkk -T-OX Use BLUE or BLACK Ink Far Office Use l I I g 353 ' Permit#: City of Ea~UR l Permit Fee: 1 3830 Pilot Knob Road t Date Received: d sq I Eagan MN 55122 Phone: (651) 675-5675 I Fax: (651) 675-5694 1fi 1 I L tW 2013 RESIDENTIAL BUILDING PERMIT APPLICATION 6;6tdN TCrrQiG~ Date: ko r_Z`l" 13 Site Address: 3760 7 37U°~ 7GrG 37Vg 37>O UnitM Name: Phone: Resident/ t i Owner Address / City / Zip; f Applicant is: Owner Contractor Description of work: ® Type of Work ° Multi-Family Building: (Yes / No Construction Cost: 71 5 1. Q ©O Company: 't- ~tcltvt~r¢c.4J ~~R ns~Vcriv^•- --Contact: t &0 City: (r + + ~ i+ne lka~,l~m- E Address: Contractor i State: 01 A) zip: ~3`43 Phone: I # License f#:L Lead Certificate !MT' If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) S - ~ . t_cJ A- - /A w-4 ~Je- COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issueda 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.^Pottions 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. r _ 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. 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 Cade must be completed within 180 days of permit issuance. Applicant's Printed Name Applicant's Signature Page 1 of 3 2 �j �( ,Q J�b� ,�� � J l � � U � `�� � Use BLUE or BLACK Ink ----------, � For OfFice Use � ��} ���� � i Permit#: � � � 4" � • � Permit Fee: _ ._ . V . 3830 Pilot Knob Road t; , , ' � Eaaan MN 55122 � � Phone:(651)675-5675 � Date Received: � Fax:(651)675-5694 j i � Staff: �����__����������J 2014 MECHANICAL PERMIT APPLICATION ❑ Please submit two(2)sets of plans with all commercial applications. Date: Site Address: Tenant: Suite#: . � .. _r .,, /( ( 1�,�2- °��I 0- �c S� �..,�. _, � �° ° Name: \U� 1 P�( ��f 1� Phone: � Resident/Owner . �- _ , Address/City/Zip: � _ �- -L —� �� `� � Name: t i �,� d' License#: � � � � ��J� �' "`��� Address: i��–1� ���.1��Y�1 I t l i � � S"► City: t�(,t.0�{rl�:� �` (s'o rac or�,�, � �� � ��,�� State: V�� Zip: �����Phone: � ' � �� � �: „c�,r.� �: ., Contact: Email: Il n f� f� f�L�(..�'C�1Y �U`j'y) ���: ��` New �Replacement _Additional _Alteration Demolition �� �� — -,��'y�g�pf�� . Description of work: " `" r OTE:Roo moun e n roun oun ed mec anical e ui me is�wre �o be screene'"�b �t�� , .� . `'� �` °`�- �` �,� ease o c •he ec a a ,�nspec or�o��n�or�na io�o xp�erm e sc eeni g me o s`�� .�a�._�z:�-..,...�_.�� �.� s��.�_ . .�. � ,�.�........_ »��w�.�:�. -�.-�� � � -� ��: RESIDENTIAt COMMERCIAL >;�� .�,�.,"���,_.�..a.,� `� Fumace New Construction _Interior Improvement ,�� ��t,-�-��e�.� —Air Conditioner _Install Piping _Processed " °�` Y �` �"'` Air F�cchan er — 9 Gas _Exterior HVAC Unit s ",�,,�._•�....�.�,.� — ',�� ,_HI„,,,„��,n _Heat Pump _UndedAbove ground Tank (_Install/_Remove) �::u..� �.�� `Other � RESIDENTIAL FEES $60.00 Minimum Add or alteration to an existing unit(includes$5.00 State Surcharge) dv $100,00 Residential New(indudes$5.Q0 State Surcharge) _$ �� ° T�TAL FEE ' COMMERCIAL FEES Contract Value$ x.01 $55.00 Permit Fee Minimum $70.00 Underground tank installationlremoval =$ Permit Fee � *If contract value is LESS than$10,010,Surcharge=$5.00 =� Surcharge* **If contract value is GREATER than$10,010,Surcharge=Contract Value x$0.0005 �- • ***If the project valuation is over$1 millton,please call for Surcharge � _$ ' TOTAL FEE I hereby acknowledge that this information is complete and accurate;that the work wili be in conformance with the ordinances and codes of the City of Eagan;that I understand this is not a permit,but only an appiication 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 C��C�� ���-� X���������.��--� ApplicanYs Printed Name Applicant's Signature FOR OFFICE USE " • ' � ° '' � .,� > Required InspecUons w�_. �'_���.� _ _ �._�.,�Revie� e By�. z..�;».�,�.�t«�:�,�.. . ��� � " ��� .� ��::_ .".> �Date• �.; : _,� � _ ___ .�� , r . � n"'�e roun `�``Rou n �-� ir� es ''��"�Gas e ice es �-� - oo ea _ nal,�._•�-.w ' G�cree i " , r9 9.�,,,,_. - �� ,.�,�..�„�19�:;;,� PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA129174 Date Issued:01/15/2015 Permit Category:ePermit Site Address: 3762 Golden Hill Ter Lot:2 Block: 08 Addition: Town View 1st PID:10-77100-08-020 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Heater & Water Softener Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Applicant: Jennie Wood 5720 International Pkwy New Hope, MN 55428 Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087 Surcharge-Fixed $5.00 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 - Suzanne L Morfitt 3762 Golden Hill Ter Eagan MN 55122--112 (612) 940-9657 Benjamin Franklin Plumbing 1424 N 3rd St. Minneapolis MN 55411 (612) 604-4285 X61 Applicant/Permitee: Signature Issued By: Signature