4125 Ruby Lane
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la3 A k t,51 A ► ~)"j t 41 Rq g Ili' 1S~NW Use BLUE or BLACK Ink
I For Office Use
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City of EaK an Permit
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3830 Pilot Knob Road Permit Fee:
i 1
Eagan MN 55122 1
Phone: (651) 675-5675 1 Date Received: Ind k 1113, ~
Fax: (651) 675-5694 1
Staff: n^f)
i-----------------1
2013 COMMERCIAL BUILDING PERMIT APPLICATION (1o
Abel I°Il~il ~
Date: C~1 12-7/ t3 Site Address: G~(OJ' 4 _ ~1Z31~rzS~ y►zilyl~g ~J~ t~4~O~{ G`_
V
Tenant Name: Q~ F~th (QMft5 komtajenant is: New / X, Existing) Suite
Former Tenant: Q
Name:D 4.0m\oAs a, SAW-1 OtAl %!?Kr n I,MS Phone: 4 3;L- 81 7 9
Property Owner Address/ City /zip: RD Do)( 5 C1C3eh0Jv4 MAI 5'S b$
Applicant is: Owner Contractor
Type of Work Description of work ► Cc~t' d ic~ - Coy~ GK C1„nit 5 a . ~h Ct C-
~y
Construction Cost: 5 S 1 b 3 3 1
Name: O " C ov\.~ (-%xC -i a License lJ 22,11-1:L
Address: IL L IL C `ojv\dt omic - City: I05L MOJvl T'
i Contractor 4
State: Zip: T50(69 Phone: GPI " 2 1(.5
Contact: Email: ~Lut ~d ~e~~tC~ 0~5. Ca•o~'1
Name: Registration
}
Architect/Engineer Address: city:
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 they 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.goi)herstateonecall.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.
x LI~, I x IJ~a I
o L
Applicant's Printed N We Applicant's Signature
Page 1 of 3
3830 PILOT KNOB ROAD 1 EAGAN, MN 55122-1810
(651) 675.5675 i TDD: (651) 454-8535 j FAX: (651) 6T5-5694
buiidinainsoections0citvofeaaan com
Date:
-----------------
For office Use 1
I Permit #: 1
I I
t 001
I Permit Fee: I
t I
Date Received:
I I
Staff: i
----------------
2022 RESIDENTIAL PLUMBING PERMIT APPLICATION
Site Address: 9 ) a S
s
Tenant:
Resident/Owner I Name:
re 4- �� 8 �' 4 -hone:
v �S Lc
I Address / City I Zip: / 12 S ht
Contractor
Name: Hessian Plumbing Services
Address: P.O. Box 22172
State: MN Zip: 55122
contact Mike
Suite #:
Ss��2
License #: PC644358
City: Eagan
Phone: 651-681-8252
Email: mike@hessianplumbing.com
5 New Replacement _ Repair _ Rebuild _ Modify Space ,_. Work in R.O.W.
Type of Work
Description of work-
--
T�less Water Heater Lawn Irrigation (_ RPZ / , PVB)
y Standard Water Heater Add Plumbing Fixtures (� Main I Lower Level)
3
Description Water Softener
Description:
Septic system --
Connection to City Water from Well
New Abandonment
RESIDENTIAL FEES
$60.00 Water Heater, Water Softener, or Water Heater and Softener (includes State Surcharge)
$60.00 Lawn Irrigation (includes State Surcharge)
$60.00 New fixtures, adding or rem ing piping (includes State Surcharge) 0 ,, ,, er
$60.00 Septic System Abandonmentr
$100.00 New Residential (fee collected with Building Permit) C 1 4 3 G
s
$115.00 New Septic System (includes County fee and State Surcharge)
$60.00 Connecting to City Water from Welt* + $300 for Meter and $205 for Radio Read = $CES$,LO.
*Sewer & Water Permit also required for connection charges i
TOTAL a0
LCAI.L BEFORE YOU DIG. Cali 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.gopherstateonecali.om
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.citvofeanan.comisubscribe.
I hereby acknowledge that this Information Is complete and accurate; that the work will be in c onforrnance 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.
XMike Schiltz X k -LP",
Applicant's Printed Name ApplWarift Signature