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3773 Burgundy Dr ~ccj 1d Use BLUE or BLACK Ink r 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"' ~vr 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