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3642 Burgandy Dr From:ALLSTAR CONSTRUCTION 19529427464 09/03/2013 10:19 #482 P.038/043 3to~o I `3 o4a, 3644, 3b Lkl Use BLUE or BLACK Ink For Office Use I City of Eap ; Permit s 5 I -LL I l 3830 Pilot Knob Road Permit Fee: 3 OQ I I Eagan MN 55122 ; Date Received: Phone: (651) 675-5675 I I l Fax: (651) 675-5694 I Staff: I I Q, 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: V 2 I 10 1.3 Site Address: aLA, - Resident/ -Unit Name: Phone: Owner Address / City / Zip: Applicant is: Owner Contractor pe of Work Description of work: Vic- T, YOLA -Alad Yt - sl d.I Vin Construction Cost: k 000 Multi-Family Building: (Yes Company: IS{7l{r 1SCYIAC._ _L)Yl ~ZIN17901P.YV1Mt Contact: I C{~~(o4 Contractor Address: 5145 Indu►St -Al St Suit 103 City: lU1~lDlfi Pty i n State: Zip: CJCJ soI Phone: 952' C19I 95jy l License t:~~I51~ _ Lead Certificate t Z~~y ~O If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) m 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 s Sewer & Water Contractor: _ Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. rtionso f the information maybe classified as non-public ►f you provide speciFc reasons that would permit the City to CALL BEFORE YOU DIG. Call Gopher State One Catt 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.oopherstateonecalt ora f 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 tate Building Code must be completed within 180 days of permit issuance. X" olu ~t I s+e a d x Applicant's Printed Name Appli s Signat e Page 1 of 3 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA158129 Date Issued:09/26/2019 Permit Category:ePermit Site Address: 3642 Burgundy Dr Lot:803 Block: 04 Addition: Centex Vermilion PID:10-16935-04-803 Use: Description: Sub Type:Residential Work Type:Alteration Description:Fixtures 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. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Fee Summary:PL - Permit Fee (miscellaneous)$59.00 0801.4087 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 - Kelley L Hemken 3642 Burgundy Dr Unit 803 Eagan MN 55122 (920) 321-8908 Perfection Plumbing 9633 211th St W Lakeville MN 55044 (612) 867-1192 Applicant/Permitee: Signature Issued By: Signature