3773 Burgundy Dr
~ccj 1d Use BLUE or BLACK Ink
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For Office Use ( ` I
Permit t 1
City of Ea
Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675
Fax: (651) 675-5694 I Staff:
I
>013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: IQ cY / 3 Site Address:377/'3-7Z -377-5' &^d Unit
Name: yG-12 Cc 4 1" , 5- Phone:
Resident/
Owner Address / City / Zip:3771-3773 -172d"'
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Applicant is: Owner Contractor
Type of Work Description of work:,
Construction Cost: - Multi-Family Building: (Yes No
Company(2/72-es- )%Io Zr4e7e,1Ce Contact: R111 MgsaC 1~.
Contractor Address:, h~ -T--
Contractor &D city:
State-2&Z2- Zip:,jsGf l3 Phone: _e" -3-,?1- 04-0 9
License Afo 410 Lead Certificate #:/-1 - 791 - I
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
I
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?
i
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
i
a
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
I 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 St 'Iding Code must be completed within 180
days of permit issuance.
x- 53 t
Applicant's Printed Names Applica ignature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA152302
Date Issued:10/09/2018
Permit Category:ePermit
Site Address: 3773 Burgundy Dr
Lot:2 Block: 03 Addition: Seneca Hills
PID:10-67125-03-020
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.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
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 -
Patrick Tste B Cleary
3773 Burgundy Dr
Eagan MN 55122
(704) 953-8696
Aeshliman Plumbing Inc.
307 Jackson Ave. Suite #4
Elk River MN 55330
(612) 290-8959
Applicant/Permitee: Signature Issued By: Signature