1829 Merlot Curve
f Use BLUE or BLACK Ink
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City of Evan4 Permit
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v~ - I Permit Fee:
3830 Pilot Knob Road I
Eagan MN 55122 1 Date Received: ! Z 1-24 0 ~=Z
Phone: (651) 675-5675 I Staff: Z\vn
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Fax: (651) 675-5694 i -
2011 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: Site Address:
Tenant: Suite
1. "A F 0
RESIDENT 10 WNER Name: Phone:/ h)
Address / City/ Zip:
CONTRACTOR Name: MILBERT COMPANY INC.dba CULLIGAN WIDER
Address: 1801 50TH ST EAST City, INVER GROVE HGTS
State: MN Zip: 5507 Phone: 651 .451-2241
Contact: BILL, MILBERT, Email:
TYPE OF WORK _ New %eplacement _Repair -Rebuild , Modify Space - Work in"R.O.W.
Descri tion of ork
PERMIT TYPE RESIDENTIAL
Water ater Softener
Water Heater
Lawn Irrigation RPZ PVB) Add Plumbing Fixtures t` Main Lower Level)
Septic System Water Turnaround
-New
Abandonment
RESIDENTIAL FEES:
$55.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$35.00 Lawn Irrigation (includes $5.00 State Surcharge)
$55.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround" (includes $5.00 State. Surcharge)
'Water Turnaround (add $166.00 if a 5/8" meter is required)
$105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
$95.00 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $5.00 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.aooherstateonecall.oro
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 wit a approved plan in a case of work which requires a review and approval Ian
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Applic n 's Printed Name Applicants Signature
FOR OFFICE USE Reviewed By:
Required Inspections Under Ground c ',Rough-in.' ~_Air, Test Gas Test Final
From: Parsons Exteriors Inc Fax: (888) 426.9712 To Fax: +1 (651) 675.5694 Page 24 of 269/26/2013 8:24
119e-EILUE car BLACK Ink
For [Office Use !
Perm
141,
ity of Eapt
Permit ree c a5
3836 Pilot Knob road )
rt l ~l ~ ~ I Date Re ti a~ 13
1'l~~rr~: ¢6511 ~i75-56'T5: f t
Faxt(651) 675-5694 1 staff
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:013 RESIDENTIAL BUILDING PEf MIT APPLICAT°IO
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Date: dde. _ nor
~Pk1ar3G...m..~ may =.,~r.~ ~ .
Name:
Resilden
to ner Address I City] Zip: ~ it.
Applicant is Owner Contractor
yDescription of work ice' ✓ ~~f~ §t d_
Type of Work
Construction Cost. I~..: rvluiti-Fornily Building: {Yes V1 hlo
Contractor Address* ~~~-{r t .
t ate: Zp Phone'
77 7 -Z?
-7 b
License - Gl Lead Certifi"ter#: 2 1.1 S-F! .
I tha p ajef t s x ptfrorn tea~d certifiestion, please explain wh : (see Page 3 tvr additional informaCion
L-7- 17718 4
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the task 12, months, has the City ofEagan issuad as permit for a sinn3lar plan laased'on e master plan?
Yes No if yew date and address of master plan
Licensed Plurriber:: Phone:
Mechanical Contractor; Phone:
Sewer Watsr Contractor:. PhonW, _
NOTE, Playas and supporting dpeumeniP that you submit are considered to be public ii;formatiosn. Portions of
the information may he classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
CALL BEFORE YO E # DIG. Call Gopher State One Gan at (651) 454-0092 forp[otepuon against underground i Why darnage: Cail0 tours .
before Vow intend to dig to receive tocates of undergo-)und utilities + r>> flrz,~tt~r ,reu_ e~ 3EI:o:i hereby acKncmlledge that this information is complcte and amursts; that
the wprx w.11 tae in conformance, Mth this ordinances end MdcJs of the CRY of
agan Lhat I understand this is no!.a pewiit, but only an application for a pemid, and work is not to start without a permit: That :he vro;-R Mli be in.
accordance- with the epproved plan in the case of work which requires a review and appnotrai of Plans.
E)ae for work authorized by a building permit Issued in accordan4e with the Niinnescrta State 80cltng Cade must be completed, within 180
days of permit issoarrce.
ApPHcanrs Printed Name AppliGarft gignaturePage -1 ai' 3
Use BLUE or BLACK Ink
For Office Use
1111!!!1/1'
Cityof Eaaau Permit#:
Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 A"� ' : LIN Date Received: 14 17
Phone:(651)675-5675
Fax:(651)675-5694 Staff:
4. J
�(( 2017 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: `I/sin Site Address: 1 SZ ) 1 p c-°\ in-5 1'444./ GUAR,_ Unit#:
Name: Phone:
Resident/
Owner Address/City I Zip:
Applicant is: Owner, Contractor
T e of Work Description of work: (tel.' C
yp
Construction Cost: Multi-Family Building:(Yes/ /No )
Company: \--)Gn dv-15 Co✓l 511 V(41i ov Contact: SItiv--, 3 s.v J c--
Contractor Address: \ .4,(T1.0 T--0"001 ILO City: Ctw,L Cc
iki
State:AAA Zip: SS1.)IZ, Phone: (Qil -161Cl- Email: U*1" c itelUryj 1- Co"---
License#: ,iO3c1-1 g Lead Certificate#: f1)#
If the project is exempt from lead certification, please explain why:
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:
Fire Suppression 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 theyare trade secrets.
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.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.
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 c v 5h�. 11111W0-41•
Applicant's Printed Name
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