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4468 Glen Echo Bay CIO 1~ r---------------- I For Office Use I I 210 Permit City of a I- I Permit Fee: 3830 Pilot Knob Road I I Eagan MN 55122 1 Date Received: Phone: (651) 675-5675 j Staff: Fax: (651) 675-5694 I _ _ _ . _ 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: ? -5- r7 Site Address: 2 , Tenant: Suite RESIDENT / OWNER Name: Phone: Address / City / Zip: Applicant is: Owner Contractor TYPE OF WORK Description of work: Construction Cost: Multi-Family Building: (Yes / No / ~s r CONTRACTOR Name: L ) / 1 s' l ~'~L c'LO_ License Address: /z',) f2 .--aGl7/7'/f `'t J fG ~i/ State: H14 Zip: City: / ~(~I`: wL"11-~/ Phone: / 2- 6i Z-0 Contact Person: el l 6g ~5cA COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 Minnesota Rules 7672 Energy Code < Residential Ventilation Category 1 Worksheet New Energy Code Worksheet Category Submitted Submitted (4 submission type) . Energy Envelope Calculations Submitted 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 the information may he classified as nor-public if you provide specific reasons that would permit the City to conclude that the .are trade secrets. 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 Iccordance with the approved plan in the case of work which requires a review and approval of plans. Applicant's Printed Name Applican 's Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA124718 Date Issued:07/09/2014 Permit Category:ePermit Site Address: 4468 Glen Echo Bay Lot:008 Block: 02 Addition: Cliff Lake Townhomes PID:10-17790-02-008 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. Troy Good 3670 Dodd Rd Eagan, MN 55123 Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087 Surcharge-Fixed $5.00 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 - Stephen M Juckem 1910 Covington Ln Eagan MN 55122--245 Champion Plumbing 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 Applicant/Permitee: Signature Issued By: Signature