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Unit A Use BLUE or BLACK Ink r-----------------I I For Office Use I a ' EC Permit l go? e 7 I Fbi~ yof EapC E IVE I Permit Fee: vV 3830 Pilot Knob Road Eagan MN 55122 JUN 0 2 2014 i Date Received: -o?r Phone: (651) 675-5675 Fax: (651) 675-5694 BYM/--A -12-0? 9 L--Staff: 2014 RESIDENTIAL-PLUMBING PERMIT APPLICATION Date: Site Address: I G C`lf 1 1 r~,on Dr Tenant: Suite Name: Phone: Resident/Owner Address /City/ Zip: K bo~ A 0 (rm'< Name: ~rvtk ~ ~ t_ice se Address: CA OCity: Contractor State: _ Zip: ~`1 l Phone: G I -9j9-0q y9 w C~, k Contact:, )1~ '.X%h®6-( Email: 01X i Type of Work -New X Replacement _Repair -Rebuild - Modify Space - Work in R.O.W. Description of work: RESIDENTIAL r Water Heater Water Softener Lawn irrigation RPZ PVB) Permit Type { Add Plumbing Fixtures Main J - Lower Level) Septic System New Water Turnaround Abandonment Y RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) r $60.00 lawn Irrigation (includes $5.00 minimum State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge) y *Water Turnaround (add $200.00 if a 5/8" meter is required) $115.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) j~ TOTAL FEES $ L/ 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.ciopherstateonecall.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 pro of plans. X )I M sc-'~ (3 6(f,( Applicant's Printed Name Applic 's Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: Under Ground Rough-In Air Test Gas Test Final Me**t R laced lull s: Mdt~r ~ i. Radio Read ta€f:.; PERMIT City of Eagan Permit Type:Building Permit Number:EA139520 Date Issued:10/26/2016 Permit Category:ePermit Site Address: 1600 Clemson Dr A Lot:57 Block: 01 Addition: Thomas Lake Heights 2nd PID:10-75951-01-570 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 4,000.00 Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 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 - Molly J Clark 1600 Clemson Dr Eagan MN 55122 (612) 812-5031 Window Concepts Mn 291 Eva St St Paul MN 55107 (651) 905-0105 Applicant/Permitee: Signature Issued By: Signature