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3764 Golden Hill Ter 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 Eagan 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: 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 PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA141190 Date Issued:02/27/2017 Permit Category:ePermit Site Address: 3764 Golden Hill Ter Lot:3 Block: 08 Addition: Town View 1st PID:10-77100-08-030 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. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State 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 - Teresa A Erpenbach 3764 Golden Hill Ter Eagan MN 55122 (612) 618-8900 One Hour Heating & Air 1904 Vermillion Street Hastings MN 55033 (651) 437-4177 Applicant/Permitee: Signature Issued By: Signature & Use BLUE or BLACK Ink 14' • For Office Use -1` it" 1 9 2017 Permit it: i�t/A-7 Cg ray of Eapn r_ ;ap Permit Fee: l.Y 3830 Pilot Knob Road 7Eagan MN 55122 Date Received: .7'(G! `I Phone: (651) 675-5675 Fax: (651 - 94 LStaff: J I +'2017 SIDENTIAL PLUMBING PERMIT P'ERMIT APPLICATION Date: 6P'' T Site Address: (D CI 1..6c/ . ``Wt( li -r( M&5P-a, Tenant: , ' Suite#: b til - { � ,Sc itf'} s�:� t}t tt#H.:rs*j. 6)17-1'700 � NI ll q�w rt Name: / l Phone:��s O � �� te' i f a t +, „} ,; o ; t ,it} Address/City/Zip: d e�01. PA-A4 1 1A O • 2oyt , Sa0 }t,, • U ';';',4.A!,': ,1,::'":/%':.�sA k,r1�-��'iC �. Name: (�Cati ?,(-) �/�License#: C t{:y r itr C Address: \ Q( �O '\ ' c(.6+ City: \V'� 1 2(Ut tai^ i,„,.. - ,. 1 'c i 'tr}511,�s f,. State: Y) t Zip: _ Phone: C -`` 1 �� ,vlia tom{ ,- rl't ,y! lir 9 \A//,,K!//, �..XJ ' �.�<�,,��t,�,ik <;�14s;ir•''ta�t�t•� Contact: / • �• �(' 4 � Email: L4.�a. ♦ Q �I ` �/ lr� • #�, iFol ,.44+'1•04,0,f ,-�? rP • l „ ' �t New Replacement _Repair _Rebuild _Modify Space Work in R.O.W. `• `�� z Description of work: 1 t :t, _ .4i,yet ' 1' RESIDENTIAL ;r is I ; i,( t i',t�rY,ti, .istt O( *. `1 l i h {yt ` Water Heater • ,4 i)./..,. `t �; °A Water Softener ,#'t +`` it .�t, y*• iY'4,9,},� Lawn Irrigation(__RPZ/—PVB) �A_.t Add Plumbing Fixtures ( Main/_Lower Level) } t ,”, w.> i �� Septic System } ,IR tty1r,,+, 1 .'t. P Y 'F)., '�} liak`'iv;*1 New Water Turnaround t ; y r'. t : 4 n'; 1i *;t, Xi*,f1,} —Abandonment RESIDENTIAL FEES: ,. $60.00 Water Heater,Water Softener, or Water Heater and Softener(includes State Surcharge) $60.00 Lawn Irrigation(includes State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment,Water Turnaround*(includes State Surcharge) *Water Turnaround(add$280.00 if a 3/4"meter is required) $115.00 Septic System New(Includes County fee and State Surcharge) TOTAL FEES $ 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.gopherstateonecall.orq 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 :1ztWV' i16 cseo,wOqfires a review and apl4-1V1‘... irc\ t t x Applicant's Printed Name App icant's Signature �i[��,�„, a r 41 �ttr!�!''+�1 a• S i s'J','; -# vi {, , ,.+ �, y u ritp,:7,77'47-7,77:7-47-J.7777-74 � �vR�iR�,e„�,,,,IL'r v r,�. ',.$' yi � '��''rfi� � � �, `�n`.ie .t`"` #`x'�,,.�S��v 4_.i�},�3 � #`ryu�ifv.41-w. t �FQ ®, tf,, , ,.-. , r�.,.. vI=wesi. r t:^t8 z its` „t,4.f+s r . £-z t'x- 0 . 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