1876 Sapphire PtPERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA111099
Date Issued:06/11/2013
Permit Category:ePermit
Site Address: 1876 Sapphire Pt
Lot:121 Block: 04 Addition: Diffley Commons 2nd
PID:10-20451-04-121
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description: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.
Kris Oien
3670 Dodd Rd
Eagan, MN 55123
Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087
Surcharge-Fixed $5.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Mary Ann Roudebush
1876 Sapphire Pt
Eagan MN 55122
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature
BONA, ~5-7(QI leb I b 1 1$~0(1e82, 108 4
t a~~ t `~S~ i 18G~p1 , $G~2 I ' $G~Gt.~ '$~(0 Use BLUE or BLACK Ink
U r - - - - - - - - - - - - - - - - i
w, ee I For Office Use
Permit
City of Ea oa~
u b I Permit Fee: l~~ J
3830 Pilot Knob Road I
Eagan MN 55122
I
I Date Received: to
Phone: (651) 675-5675
Fax: (651) 675-5694 j Staff: I ~S
t-----------------I
2013 COMMERCIAL BUILDING PERMIT APPLIQATION I2- '
C~ 18X 5781/SSd/IE8_St/ 5gPPh1,-e Ft
Date: 1 27 Site Address:7?/ f3g., //f?g"I /IfQD/189Z~11~,~/8Y6
Tenant Name: Q~~rOkt!1 CoMft-S ~.i►\~S $-%I Var~c4 komlajenant is: New / > Existing) Suite M
Former Tenant: Q
Name: C._VN0hs X yak&IS AAA gV rA,, wmS Phone: C S*A- 4 3 A-8171
Property Owner Address/ City /Zip- P-0 DOX J hOSehoJv► Am JrJrO (o$
Applicant is: Owner Contractor
Type of Work Description of work7eA O ~C- X12. - ('oo~ G-K ~ Kn r 5 a . nh Ct ~a~ C`
Construction Cost 177,3
Name; O ~ COV ~ C%x1i o License lJ C_ ~aZ ~ t e1
Contractor Address: ~1e\p~ L ~~ow~c~t pvG.- City: 1050- M0J%
State: M~J Zip: 5 S~~Q Phone: `1 9 ('06-
Contact: Email: LGvi
Name: Registration
Arch•itect/Engineer Address: City:
State: Zip: Phone:
Contact Person: Email:
Licensed plumber installing new sewer/water service: 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.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.goi)herstateonecall.orrg.
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.
x L,~, I O x 3MA
Applicant's Printed N We Applicant's Signature
Page 1 of 3
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