1523 Clemson Dr BPERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA126806
Date Issued:09/10/2014
Permit Category:ePermit
Site Address: 1523 Clemson Dr B
Lot:10 Block: 03 Addition: Thomas Lake Heights
PID:10-75950-03-100
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.
Tony Boerner
2090 County Road 42 W
Burnsville, MN 55337
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 -
Ferade J Ferasol
1523 Clemson Dr Unit B
Eagan MN 55122--289
Tony's Appliance
2090 County Road 42 West
Burnsville MN 55337
(952) 435-2442
Applicant/Permitee: Signature Issued By: Signature
CITY - OF' EAGAN WATER SERVICE PERMIT
3795 Pilot Knob Road PERMIT NO.:
Eagan, MN 55122 DATE:
Zoning: _ No. of Units:
Owner: - —
—
Address:
Site Address: _ Plumber:
Meter No.: __ Connection Charge:
Size: Account Deposit:
Reader No.: Permit Fee:
1 agree to comply with the City of Eagan Surcharge:
Ordinances. Misc. Charges:
_ Total:
By Date Paid:
Date of Insp.• / Insp.:
CITY OF EAGAN SEWER SERVICE PERMIT
3795 Pilot Knob Road PERMIT NO.:
Eagan, MN 55122 DATE:
Zoning: No. of Units:
Owner:
Address:
Site Address:
Plumber:
agree to comply with the City of Eagan Connection Charge:
Ordinances. Account Deposit:
Permit Fee:
Surcharge:
By Misc. Charges:
Date of Insp.: Total:
Insp.: Date Paid:
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Use BLUE or BLACK Ink
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For Office Use I
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City of tap Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 1 Staff: I
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2013 RESIDENTIAL BUILDING
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Date: Site M~ IT A~P` lPL~ jIC V t ATION
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"je Y I o Address:
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Name: 1
Resident! - ~ - ` , '
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Owner Address / City / Zip:
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Applicant is: Owner Contractor
Type of Work Description of work: ~ 11 W4 CAffAA Limului CAI - 91& m Nf
Construction Cost: V Multi-Family Building: (Yes X / No )
Company: LL f1occ IY)0) a-A't Q2"_d(d rnJ `Eontact: ~&Uwt yr `V 1
Address: CI )()G f ,~C11~SIC~v- 6%Jd City: _S4 LC3u-
Contractor
State: MV Zip: S~y Phone:
License 0-1Q_0D LU Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
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 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.cioi)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.
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 [/l 4 Po'A.Miv-,'~
Applicant's Printed Name App ' 1Vs ig ature
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