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3739 Burgundy Dr Id Use BLUE or BLACK Ink For Office Use I Permit 3 ~ I City of Ea Rd~ ~ l Permit Fee: 3830 Pilot Knob Road I I Eagan MN 55122 Date Received:' - ; Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: I 20213 RESIDENTIAL ?BUILDING PERMIT APPLICATION Dater cJ Site Address: - 3 J 7 `7 - 37 VI &zr - Unit i Name: Phone: Resident/ Owner Address / City / Zip:3731-373 9 -3-74// t9ci u~io% ,di Applicant is: Owner Contractor I Description of work: , Type of Work Construction Cost: Multi-Family Building: (Yesx / No Company: U001e.: ~cs!/~! /sl~JieG Contact: Contractor Address:3/00 su,0711ne-r 5✓ ~J City: ~d ~.S`' - 01 State: M/) Zip: -s•$"~/~3 Phone: _ Z/.? -13 00- 9460 License Be- ;2 6-.2a VC) Lead Certificate °-~37 9/2 V j 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 I 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: i 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 the 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.oopherstateonecall.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 Applicant's Printed Name Applica s igmature Page 1 of 3 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA131879 Date Issued:07/13/2015 Permit Category:ePermit Site Address: 3739 Burgundy Dr Lot:2 Block: 05 Addition: Seneca Hills PID:10-67125-05-020 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. 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 (WS &/or WH)$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 - Jeremy J Krehbiel 3739 Burgundy Dr Eagan MN 55122--316 (651) 324-0689 Champion Plumbing 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 Applicant/Permitee: Signature Issued By: Signature