1525 Woodview Ave W Use BLUE or BLACK Ink
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V ~ctcv I For Office Use 1
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Permit M
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City I
Eataff I I
Permit Fee: ~ I
3830 Pilot Knob Road I Date Received:nff7.I t
Eagan MN 55122 DEC 01 013
Phone: (651) 675-5675 1 Staff-
Fax: (651) 675-5694 1------ I
2013 RESIDENTIAL PLUMBING PERMIT APPLICATION
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Date: (l Site Address:\ 1`~Q r
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Tenant X11 'L L~~\ 1 l.) Ct Y__ Suite
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Resident/Owner Name: Phone: LP S
Address / City / Zip: ...~~....m. ~~.~..:~,.n,.M'1mj m.,.~.
IL License*
Name l `C l~
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Contractor Address: `t~-- City:
State:\~Q1_ Zip: Phone D (Z~D C
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Contactl__~Ty__" Email:
Type of Work New Replacement _ Repair _ Rebuild _ Modify Space Work in R.O.W.
Description of work:
RESIDENTIAL
Water Heater
Water Softener
Lawn Irrigation RPZ PVB) 3
Permit Type Add Plumbing Fixtures Main Lower Level)
Septic System
New Water Turnaround
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Abandonment
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
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 aopherstateonecali.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 tans.
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App rcant's Printed Name Appll nt's rgnature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: -Under Ground -Rough-In -Air Test ^Gas Test -Final
From:ALLSTAR CONSTRUCTION 19529427464 05/07/2014 10:07 #166 P.005/037
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523 1c 152"/ ° 152°1 oodv t ~ Ave- W
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Use BLUE or BLACK Ink
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For Office Useh l
j Permit `2 454
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City of EadH I Permit Fee:
3830 Pilot Knob Road I .~C
Eagan MN 55122 j Date Received: 151-1
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 i Staff: 71~t"~
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2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 5-1-14 Site Address: 1523, I52(; 191.11 V;Vl wuiAVIII v Wtsf (hildiol? -TOWnh°trnz)
Name: S C ' lffbi a..:-a Cr~- .>Phone:
Resident/
Owner Address/ City/ Zip:
1P43 a CI 3 W , POIr Edti h lai Yi GTM N 5S31-f `I
Applicant is: _ Owner ~ Contractor
I Description of work: My
Type of Work
Construction Cost:, &cjCJO.OO Multi-Family Building: (Yes X / No
f Company: AIIS-hy tQ1QS1 ChDn MOIAtY11GYf, LUG Contact: tayle MtLACYOIDItrt
Address: 5115IhdvlsMIJ SJ_ 4I0:s
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- MP f PI011n
Contractor I City:
I State: _MNZip: 553151 Phone: IVLIL-1439 Email: Clahf (S OIIISt r . bL
License Lead Certificate N PCT- 21701(0`1 - 0 II
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) 3 ~~3
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
I
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan.
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
sewer & water contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
i the information maybe classified as non-public if you provide specific reasons that would permit the City to
econclude that then 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.aopherstateonecall.oro
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 State Building Code must be completed within 180
days of permit issuance.
x 1dw McbeempT x
Applicant's Printed Name Applicant's Signature
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