3569 Blue Jay Way, Unit 102Citi of Eke
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
EU Z 9 0 AON
r
Use BLUE or BLACK Ink
For Office Use �` m
Permit #: 11 O w g
Permit Fee: V 0 ` 00
Date Received:
Staff:
L
2013 RESIDENTIAL PLUMBINGgPERMIT APPLICATION
-� �.`'
Date: i. 1 Site Address: I
A { 1 U 'L 0Th
Tenant: 1 1 \ 1 l ', P�' L� v1c
Resident/Owner
Name: 1 1 M /L' e, \,ot, --1-1-
Suite #:
Address / City
C�Anx 1 .t
Name 11 rr
Address: `t 'LTf_
State:\,l r\ Zip: J L .)) 4
Phone: U_ 1 LQ c N
Z License #: lii `"tCA. 'I�"
City: V► 1,/l�li
Phone: t
Contact: )ice' \ Email:
New ) Replacement _ Repair Rebuild Modify Space Work in R.O.W.
Description of work:
RESIDENTIAL
Water Heater
Lawn Irrigation (_ RPZ / _ PVB)
Septic System
New
Abandonment
\ Water Softener
Add Plumbing Fixtures ( Main /__ Lower Level)
Water Turnaround
RESIDENTIAL FEES:
$60.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$60.00 Lawn Irrigation (includes $5.00 State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
*Water Turnaround (add $200.00 if a 5/8" meter is required)
$105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
TOTAL FEES $ /11�
u-13
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage.
Cali 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq
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 1 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 plans
Applicant's Printed Name
x
Appli
ant's Signature
FOR OFFICE USE Reviewed By:
Under Ground Rough -In Air Test
Required Inspections:
CityofEa
01
LI; sco O
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
RECEIVED
AUG121016
Use BLUE or BLACK Ink
1
For Office Use el
2, �j
Permit #: 1 3i(
Permit Fee: 62 ' 0
Date Received: 7//41)--)(.0
Staff:
2016 MECHANICAL PERMIT APPLICATION
0 Please submit two (2) sets of plans with all commercial applications.
p
Date: 0} Site Address: ;2,51,9 R U A
Tenant:
Suite #:
Name: Jl 1 alt,l I % Tl C` VJ,A Phone: Lei 7-- 7L00 -1336
Address / City / Zip:
1. HN 65
New Replacement Additional Alteration Demolition
Description of work:
%/ RESIDENTIAL
Fumace
XAir Conditioner
_ Air Exchanger
Heat Pump
Other
COMMERCIAL
New Construction Interior Improvement
Install Piping Processed
Gas Exterior HVAC Unit
Under/Above ground Tank ( Install / _ Remove)
RESIDENTIAL FEES
$60.00 Minimum Add or alteration to an existing unit, includes State Surcharge
$100.00 Residential New, includes State Surcharge
TOTAL FEE
COMMERCIAL FEES
$60.00 Permit Fee Minimum
$70.00 Underground tank installation/removal
Surcharge = Contract Value x $0.0005
If the project valuation is over $1 million, please call for Surcharge
Contract Value $ x .01
= $ Permit Fee
= $ Surcharge
_ $ TOTAL FEE
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 iiasse/ j MaKkukt
Applicant's Pri ed Name
FOR OFFICE US
Required Inspections:
Underground Rough In Air Ti
x tea. kshree
Applicant's Sign
40111 CllyofEaaau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
1B2,5014
RECEIVED
AUG 222016
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee: U2 0
•
Date Received: ,a9, -I le
Staff:
2016 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: Site Address: 35 u Ci 131 ki L A C U l
/•
Tenant:
J
Resldent/Owner
Name: Mi Cil ti ki 'kG1 ati i- Phone: LO I L' 7l.@ 01330
Address / City / Zip: 9)StS q 11 LI (_,S6Lt 41 bl-
D
Name: 2nyetnB bL'cr se #: PC -U-19 3
.0
� ,
Address: • 4.' 14 & I,
MOH
4 Id City: tiaStIll C S
State: V, NJ Zip: 5-6-I2,3
Phone: SI -42)1- 41 1
Contact: i ►..di t<k. Ao_ . Email: _Kinal5 Ka.,, L t 6n 4i rr
lew )( Replacement Repair Rebuild Modify Space Work in R.O.W.
_ _ _ _
Description of work:
ermit'1�i 3e
RESIDENTIAL
Water Heater
Water Softener
Lawn Irrigation ( RPZ /_ PVB)
Add Plumbing Fixtures ( Main / Lower Level)
Septic System
_
Water Turnaround
_New
Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater,
$60.00 Lawn Irrigation
$60.00 Add Plumbing
"Water Turnaround
$115.00 Septic System
Water Softener, or Water Heater and Softener
(includes State Surcharge)
Turnaround* (includes State Surcharge)
t , j�
TOTAL FEES $ D
(includes State Surcharge)
Fixtures, Septic System Abandonment, Water
(add $280.00 if a 3/4" meter is required)
New (includes County fee and State Surcharge)
CALL BEFORE YOU DIG. Call Gopher State One CaII 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.gopherstateonecall.orq
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.
xVass Mct Ylit-11
Applicant's P nted Name
x kaAmAA, AitcLix„kox_Qt
Applicant's Sig tune
FOR OFFICE U
Required Inspect
Meter Related Item
eter Siz