2104 Water Lilly Lane
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Permit#:
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I Permit Fee:
3830 Pilot Knob Road 1 c I
Eagan MN 55122 1 Date Received: J
Phone: (651) 675-5675 1 j
Fax: (651) 675-5694 j Staff: I
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2013 COMMERCIAL BUILDING PERMIT APPLICATION
Date: Site Address:
Tenant Name: (Tenant is: New / Existing) Suite
Former Tenant:
Name: Phone:
Property Owner Address /City /Zip:
Applicant is: Owner Contractor
Description of work: '
Type of Work
Construction Cost:
Name: License
Address: - _ City.
Cot
State: /-ip: Phone:
Contact:— Email:
Name: Registration
Address: City:
Arch itect/ ngineer
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 then are trade secrets _ . .._fn _
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 re uires aview and approval of plans.
X tr` x t
Applicant's Printed Name Ap cant's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA122304
Date Issued:05/05/2014
Permit Category:ePermit
Site Address: 2104 Water Lilly Lane
Lot:307 Block: 03 Addition: Eagan Heights Townhomes 1st
PID:10-22425-03-307
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.
Troy Good
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 -
Melissa M Hanson
2104 Water Lilly Lane
Eagan MN 55122
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature