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3778 Golden Hill Ter VILLAGE OF EAGAN WATER SERVICE PERMIT 3795` Pilot Knob Road PERMIT NO.: Eaoon, 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: Zr*ning: 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: B y : Misc. Charges: Date of Insp.• Total: Insp.: Date Paid: (Q - ~'11co, 3~1$ gto Cdl~ 4' kt "ear Use BLUE or BLACK Ink -For Office Use I city o~ Permit#: I Permit Fee: 1 3830 Pilot Knob Road i I I Date Received: 2-1 I Eagan MN 55122 i I Phone: (651) 675-5675 i I Fax: (651) 675-5694 18' 1------------------ 2013 RESIDENTIAL. BUILDING PERMIT APPLICATION C~ldt~ W`II Trr4e.e- Date: 13 Site Address: 'r7U4 377$ 37$y} Ylai Unit Phone. Name: I Resident! Owner Address / City / Zip: I 1 Applicant is: Owner Contractor t Type of Work Description of work: C~Co rtiti - i Construction C Mufti-Family Building: (Yes I No ost 115, __J Company: '~o taia j, Contact: 1 t d r✓~~y +rinen4 Address: ~C) o~ i~.~ ;rctJ~ rr . City: 9 Contractor q i OYZ~! State: Zip: ~)<53`4S Phone: ` 7( License `4 5 Lead Certificate#: N lq cgoop - f 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 they are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Calf 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 withthe 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. x ctr I C k P Applicant's Printed Name Applicant's Signature Page 1-of 3 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA121846 Date Issued:04/16/2014 Permit Category:ePermit Site Address: 3778 Golden Hill Ter Lot:2 Block: 09 Addition: Town View 1st PID:10-77100-09-020 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Heater 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. Tony Boerner 2090 County Road 42 W Burnsville, MN 55337 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 - Thomas Saalborn 3778 Golden Hill Ter Eagan MN 55122--112 Tony's Appliance 2090 County Road 42 West Burnsville MN 55337 (952) 435-2442 Applicant/Permitee: Signature Issued By: Signature