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