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O�t, 2. 2014 12, 05PM Crest Exterlors 651-463-8095 P, 6
� Use BLUE or BLACK Ink
� For Offlce Use v y~ I
' j Permil#: � � � j
Clty of Ea�a� � Permil Fee; —1 u �fl �
3830 Pllot Knob Roed � I
�agan MN 55122 � Dale Received; ` � �
Phone:(651)675-5675 � �
Fax:(651)875-5694 � S�aK. �
I �
`_�....�.--.___________J
2014 RESIDENTIAL BUILQING PERMIT APPLICATION
Date:�V Site Address:��1' r Unit#:
Name:CI�� n�i �� �I 1 a 1 �.'K� Phon�U►�/J�1^ C�`��/
.�R�sJilentl � C
��gr Address/Ciry/Zlp: 7 • I
�„��ti,,^��_ Applicant is: Owner Conlractor
. � P�.�'
„e�,'�?:�-1']y,� . � n
.�-.��,�a��` Descriplion of work: 1�-�� �
$;Q,� of �.
� �r^.�� ,�3�-•,.
"`�'� ' " Conslruction Cosk� � Multl•Family Building:(Ye �l No_)
.,.__..�.... ,�:_--,:- Company:l����1 CJ\�,��l)��� i Contack��.)
�:-��� �-��-��.. Address:�Z.r)t� /_ �� �Y� '� l_l ��l - City: , 1� �
'.Q�,�tr'a�tor.: " .
'' ' � � S�ate;�Zip��1"'} Phone, O��kmall:�S � ( .rr1Q����
Llcense�F:C)C�U+'}-t Or� Lead Certlflcate#:
If the project is exempt from lead certlflcation, please explain why: (see Page 3 for additlonal inFormation}
, ,
Q� (' ►` `^Q � r � — i 1 � � , C ,
COMPLET�THIS A A ONLY IF CONSTRUCTING A NEW BUILDING
In the las(12 months,has the City of Eagan issued a pemtit for a similar plan based on a master plan7
_Yes _No If yes,date and address of master plan:
�icsnsed Plumber: Phone: �
Mechanlcal Contractor; Phone:
Sewer&Water Contractor: Phone:
NOTE:P/ans a{�d supporting dqc�irr'�enfS't" � s -`i a're con�lder" 'tl:o' �'' u6lic information.,PPorHons of
�t]`ie Inforina[ion�inaytie c1�sSrf( . �if d ' s � ^ s ns�af would pBim►f'ttie'Crfy fo
' '�~ ��c °a`�' �'��i 'frade s�cr Es�
CALL BEFORE YOU DIG. Csi�Gopher Stata Ona Call al(681)464•0002 for prolecUon agalnsl underground utllity damage. Call 4B hours
beFore you Infend lo dig to receive localag of underground uUlilles. www. o herslate I r
I hereby acknowletlge lhal lhls In�ormallon Is complete and accurale;lhal lhe work wlli be In conformance�Yith lne ordlnances and codes o(lhe City of
Eagan; Iha1 I undersland lhis is not a permil, bN only an appllcallon for a permil, entl woAc Is nof lo slart withoul a permlt; Ihal lhe work tivill be i�
accordan�e wilh Ihe approvsd plan In Ihe case of work which requlres a revlew and approval oi plans,
Exteriorwerk authorized by a building pem+tt Issuad In accordance wlth the Minnesola S te Bullding Code must he complated wlthln 180
days of permit iesuance.
x�� i ���1.�� ) x
Appllcant's P�lnted Name Applic nt's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA160403
Date Issued:03/09/2020
Permit Category:ePermit
Site Address: 3616 St Francis Way B
Lot:005 Block: 05 Addition: St Francis Wood 4th
PID:10-65903-05-005
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Standard 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.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 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 -
Susan L Goolsby
3616 St Francis Way B
Eagan MN 55123
Tony's Appliance
2090 County Road 42 West
Burnsville MN 55337
(952) 435-2442
Applicant/Permitee: Signature Issued By: Signature