1297 Kolstad Lane 09/26/2014 08:58 FAX 651 451 7740 CULLIGAN t�0001/0001
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3830 Pilot Knob Road � i
Eagan MN 55122 I Date Received: �
Phone: (651)675-5675 � �
� Staff: �
Fax: (651)675-5694 • � �
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2014�RESIDENTIAL PLUMBING PERMIT APPLlCATION
Date: - �' Site Address: �� ��
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Tenant: 1,✓B'�s1 �'� Suite iF:
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"��.��3&- r��? �.. ` } Address�City/Zip: l� J�
���'M ,, -� ��� � Milbert Company Inc dba C�Ilign Water
=� y�,�. �.����� :� Name: ��cense#: C643176
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� �� �� ':� Add�esS: 180150 , Street East �;ty: Inver Grove Hgts.
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`���:��s {��' «;<. �MN. z; . 55077 651-451-2241
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�`�, ,,:�� ,�,_,. r'��- ' � � Contact: W I I I I a CY1 R:`M I I b 2 ft. Emai�:
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� '��"��� `�' New 7'� Re lacement Re air Rebuild Modi S ace Wo�lc in R.O.W.
�'-� T:ype o�IVor.' — — P — p — — � p —
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�y''�,.�.?�'�,. `�' F�;. DeSeHptfon ofwork:
+ `��'� '2���'�> RESIDENTIAL
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���� 3a� Water Heater
,k�r�� ,� ,��: �3�_:
� ��. ,�Water Softener
s�,`r •�`� �*� ��Q - Lawn Irrigation�RPZ/ PVB)
Perm�f��Type
��,�"�- �'� �� ��, ��' �Septic System Add Plumbing Fixtures�Main/_Lower Level}
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Y
�.���`_M�� ��,' i • _New _Water Tumaround
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��:�;��` '�� � `' Abandonment
,RESIDENTIAL FEES: -
$60.00 Wafer.Heater;VVater Softener,or Water Heater and Softener(includes 35.00 State Surcharge) �
�60.00 Cawn�.lrrigafion.(includes$5_00 minimum State Surcharge)
$60.00 Add,Plurtmtiing�Fixtures,Septic Svstem Abandonment,Water Turnaround'(includes 35.00 State Surcharge)
,, .. :'Water Turnaround{add$�00.00 if a 5/8°meter is required)
�115.00:Septic SVStem New($10.00 peras builq(includes County fee and$5.00 State Surcharge) �
.. . . TOTAI FEES S �`
CALI BEFORE:YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage.
Ca1148 liours�before'you intend to diglo receive'locates of underground utilities. www.uoaherstateonecall.ora
I liereby acknowledge that this informa.ion is compfete and accurate;that tf►e work will De in Conformance with the ordinances and codes of the Clty of
Eagari;:(haG I�understand lhls fs not a permft, but ony an appllcation for a pertnil, and work is not to start wRhout a permlt;that the work wpl be 1�
accordance witfi:the app'royed plan in tAe case of woAC which requi�es a review enA approval plans.
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Applicaqt;s:Printed,Name ApplicanYs Slgnature
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For Office Use
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3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 RE.Ci 1, 0
Date Received: -7 7-/
(651)675-5675 I TDD:(651)454-8535(FAX:(651)675-5694 M Staff: it
buildinginspectionsacityofeagan.com Ar , �zp18 L r
2018 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit#:
Name: /i,.4.7
•Cv"S'ACS To w.0► 4- c -n eSohone:
er Address/City/Zip: /2 % 7 `e ci,/s 7'. .a 1-14 14 e
„,. Applicant is: Owner A Contractor C 1-.S s. /a 4vil i o r» C crC k (4/rs e A` ,C
a oWork �- Description of work: FY`d in f' f/ C'JS
Construction Cost: Multi-Family Building:(Yes)C /No )
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Company: C Vas) / O w H CGn Crc/(- ti Contact: _ � Uri ed1/3,
Address: 903 C ll yIef 001 et �� /QO,,i /A-7,fw►
ontrautor ; t/�j
':-.',,,,.',-::',--::k',,,' State/I� Zip: 5573 / Phone: 95;2 23 9 a ��l,�/�5 T!'4,6/i cd--m.-._
* License#: Lead Certificate#: /t.14=5
If the project is exempt from lead certification, please explain why:
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:
Fire Suppression Contractor: Phone:
JNOTE flans and supportmgi documents that you submit ere considered to ble„public formatio Portions of tl e�infojrmation ma ie
classified:as non -ublic if`bu vide speci c reasons that,would permittlie to+i ncludethatthe re ade s ts��, ¢`A:; :`
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.citvofeanan.com/subscribe.
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.
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.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 pl s.
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Applicant's PrintO Name Applicant' gnature
1a9.-1 OIsucx Lc tttibliig;
DO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation _ Fireplace — Porch(3-Season) _ Exterior Alteration(Single Family)
Single Family _ Garage — Porch(4-Season) _ Exterior Alteration(Multi)
Multi _ Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous
p 01 of,'Plex _ Lower Level —
Pool _ Accessory Building
WORK TYPES
New
— Interior Improvement _ Siding _ Demolish Building*
Addition _ Move Building _ Reroof _ Demolish Interior
[ Alteration _ Fire Repair _ Windows _ Demolish Foundation
Replace _ Repair _ Egress Window _ Water Damage
Retaining Wall *Demolition of entire building—give PCA handout to applicant
DESCRIPTION
Valuation �,f�,,y
2/1"- "---
;+D * Occupancy ;,.1 KC'_ MCES System
Plan Review Code EditionMn Zf/,S SAC Units
(25% 100%_) Zoning City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
2 Footings, ok) 57 °a Final I C.O. Required
Footings (Addition) Final I No C.O. Required
Foundation Foundation Before Backfill HVAC_Gas Service Test Gas Line Air Test
Roof:_Ice&Water _Final Pool:_Footings Air/Gas Tests Final
Framing 30 Minutes 1 Hour Drain Tile
Fireplace:_Rough In _Air Test Final Siding:_Stucco Lath _Stone Lath Brick_EFIS
Insulation Windows
—
Sheathing Retaining Wall:_Footings_Backfill_Final
—
Sheetrock Radon Control
Fire Walls Fire Suppression:_Rough In_Final
Braced Walls Erosion Control
Shower Pan j �j Other:
Reviewed By: I' P F I!I//" / , Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit&Surcharge
Treatment Plant
Copies
TOTAL
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