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4127 Ruby Lane 1°I toy t l ci (e (a , late tcrl0 Rwloi~ CA N la3 A k t,51 A ► ~)"j t 41 Rq g Ili' 1S~NW Use BLUE or BLACK Ink I For Office Use n r~ ~ 115gsS I City of EaK an Permit I F ~ 4~ I 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 use ts��C v� o�t�►�.n �nn ' r-----------------� i For Office Us � , I ��� I • � Permit#: � ��� ���� �� ' h � � I `�6f I � Permit Fee: � � .� I 3830 Pilot Knob Road Eagan MN 55122 � oate Received: � p��y�� t I ,�' � Phone: (651)675-5675 I Staff: »`,� j Fax: (651)675-5694 �----------------- 20�4 RESIDEN�'IAL�PL M ING PERMIT APPLICATION Date:� �/" l Site Siress: , . Tenant: �-Gy � Suite#: � ,_ � . �.� . . _ ... � _ ., . , �-.,-,-.,�,.-�,,: , t '� � ` /� '� � �������iiV'��' Name: Phone: CJ_'���J�`: ,, a: • Address/City/Zip: - � Js,��,�.�,.�,� .... _...� .�„�, . ...:,.... ,�,_m . .. . �,,,n�.,.,...,�.. .,... . . _ ._... ` �����:: � - �j'�. .--,� ;: � Name: License#: � / � ` � _� ����`d+����' Address: C . ' f ` `l � State:��Zip: � Phone: �/�) ��C Ci"7 �IG�CI� / �! <;,.:�:.::;_.:.. ` �, .. . _� � . . . r � -.�� :.��; _.l. :.�: ,. . , 4 ; Con act: - �����,�� .�� tmail: �,�,. ..:. . _ . . ...��,�,.� .�,�._-.���a�,�, . �, k �,, � � .. µ ,. ; _New �eplacement _Repair _Rebuild _Modify Space _Work in R.O.W i; � T��C;��'�Cf��t�� �. $. t�> ti� . , . ,. .<t�w�,; � � ' �, �� Description of work: _ ... ..� p; ���� ���:��,..,�, � . . p � X 5 � >` �r RESIDENTIAL �: � , � � �� �� ir � ' � Water Heater � �; � t� t -��ater Softener �' � , Zawrt Irrigatiort(_RPZ/_PL'8) ; �-������F�� ' Add Plumbing Fixtures(_Main/_Lower Level) � { ' � Septic System F � Water Turnaround �' New t � � � ` Abandonment ���„ .���,;_..�-�,-, _,.. �.-�,..�.->�.�x,������,.� m:.�„�,��.,�, .��,:m,em�:,.���.�M..�,�,�.� �a. ..,.-�.-:,�.;n�.. _.._ ,� �; � RESIDENTIAL FEES: T'� � $60.00 Water Heater,Water Softener, or Water Heater and Softener(includes$5.00 State Surcharge) �; �, x $60.Q0 L�wn lrrigation(includes$S.00minimum State Surcharge) " � $60.00 Add Plumbing Fixtures, Septic Svstem Abandonment,Water Turnaround*(includes$5.00 State Surcharge) � "Water Turnaround(add$200.00 if a 5/8"meter is required) ` ,, , $115.00 SeqtiC Svstem New($10.00 per as built)(includes County fee and$5.00 State Surcharge) � , !� TUTAL FEES$ >"` . - r. � ,-��,:.,�...� CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against un�erground utility damage. 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'`i�Y<' �`'ir .. . . . . . iu.:........ . :r._...�.......... ....,.. .. , _.,......,� .. _ �.. .7 - -... , . .... ...:,<. . .� ._.�_,:..,..,:,.. ,.u..... . .. ..f.: .. , . .... . :v. . .3. < , � . . .r. .. .. �... . � .,. r . . . . .... ... ... .... .. . .....�s. >..��'r,...;.=.: `a�i'�'�"=`, sr: - .....t �.., . ..�;..__;;:;:;., F�.I .,�". ,�`�. - 8 �"�����lc��t�'!�#� �:�����.`'"'_�,��.,:�.. .� .�;, .�.. :�-->• - �CI! �t�� „�,,..� ;<�.. ,�s.: .:�. -:�„ . . , .F.-y...n..�r.._. . . sv-.;.n�.. 3.:.;:i..:t'�'4.'�� + a . ....;.., .�...y.':.s:3 ,.:a�..... -. .Y`r•���u,� .. , . ..,s _ � PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA156036 Date Issued:06/13/2019 Permit Category:ePermit Site Address: 4127 Ruby Lane Lot:078 Block: 04 Addition: Diffley Commons 2nd PID:10-20451-04-078 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 - Diana M Stock 4347 Bear Path Trl Eagan MN 55122 Adam's On Time Plumbing & Water Heaters Llc 13791 Jonquil Lane N Dayton MN 55327 (612) 205-6060 Applicant/Permitee: Signature Issued By: Signature