4120 Running Brook Rd PLUMMMIG OM EM AL) .
Permit Application
City Of Eagan
3834 Pilot Knob Road,Eagan Mn 55122
Telephone I#651-675-5675 FAX#651-475-5694
Please complete for: Single Family Dwellings
Townhomes and Condos when permits am requimd for each unit
Date I l
Site Address P20 jPy tMewl i^c3,�d� 5 d` unit
Property Owner s !� Cc d Telephonte tt{ }
Contractor
Address � �� t..G r? �-- !�/ City
State Telephone# °
e —
wl ,0A
The Applicant is Owner Contractor Other
Septic System _ New _Refurbished Submit 2 006 of PIM and MP"
Includes County fee. Additional consultant fen may apply. 11
Alterations To Existing Dwelling Unit,Including
_ Adding fixtures to lower levels or room addftkms,excluding water softener and water heallar
_ Abandonment of septic system
Water turnaround (+518"meter if needed-$121.00)
Other:
RPZ _ new installation _ repair .
T 30.00
Lawn irrigation system
Water softener Water heater
_ replacement additional
State Surcharge 131$ .50
Total
I hereby apply for a Residential Plumbing Permit and acknowledge that the inf te;the the work.will
be in conformance with the ordinances and codes of the City of Eag=and with the Pl I understiOld this is not'a
permit, but only an application for a permit, and work is not to start without a permit; a 11 accottl4aca with the
approved plan in the case of work which requires a review and approval of plans.
l •
Applicant's Printed Name pli
r-- -------------
1 Fijr Qffice(lse.
I
City of EEagan I Permit#:
I
I Permit Fee: I
3830 Pilot Knob Road I
Eagan MN 55122 Date Received: `oi I
Phone: (651) 675-5675 1 I
Fax: (651) 675-569g� I Staff: f2
I
2008 PLUMBING PERMIT.APPLICATION
Date: Site Address: 141 l U'►�
Tenant: Lly, Suite#:
RESIDENT/OWNER Name: Phone:
Address/City!Zip:
Metro Tee!.:ti rr
CONTRACTOR Name: M License* S !g
Gary F Ov.
Address: PA Road
City: Hi.nckle '5037 State: Zip:
Phone: �0`��� -� - Contact Person:
TYPE OF WORK _New _Replacement _Repair ✓Rebuild _Modify Space _Work in R.O.W.
Description of work:
PERMIT TYPE RESIDENTIAL
Water Heater Water Softener
✓ZLawn Irrigation Add Plumbing Fixtures
(�RPZ/ PVB) (—Main_Lower Level)
Septic System Water Turnaround
_New
Abandonment
RESIDENTIAL FEES:
$50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener(includes$.50 State Surcharge)
$30.50 Lawn Irrigation (includes$.50 State Surcharge)
$50.50 Add Plumbing Fixtures, Septic System Abandonment,Water Turnaround*(includes$.50 State Surcharge)
'Water Turnaround (add$136.00 if a 5/8"meter is required)
$100.50 Septic System New($10.00 per as built)(includes County fee and$.50 State Surcharge)
$90.50 Fire Repair(replace burned out appliances,ductwork,etc.) (includes$.50 State Surcharge)
TOTAL FEES$
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 p it; that the work will be in 22j�:,accordance with
the approved plan in the case of work which requires a review and approval plans.
x C9A�� � x
Applicant's Printed Name Applicant's Signature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: _Under Ground _Rough-In Air Test _Gas'Test _Final
Jul 2516 11:33a H2C Inc 6517889657 p.3
Use BLUE or BLACK Ink
----,
For office use I
4111bo City of Eap i Permit#: Q
I Permit Fee: �
3830 Pilot Knob Road
Eagan MN 53122 i Date Received:
Phone:(651)675-5675 staff:
Fax: (651)675-5694 ----------
—------
2016 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: - _ (-P Site Address: 4QQ / !
Tenant: L , _ Suite#•
i Name: I /rl. ;1. Phone: 7 -,q-F-57
11 ResidentJOwner
r r I
Address I City!Zip: Vni
Name: License#:
Contractor
� Address: �J
State: `)Zip: �^, Phone: Ok- /"1 1 0
1 P 1'�
� Contact Email: --
I
Type of Work New _Replacement _Repair
_�(Rebuild _Modify Space _Work in R.O.W.
Description of worts: r
RESIDENTIAL /_/E7 cc e
a.
' Water Heater
{ Water Softener
I Lawn Irrigation PZ!_PVB)
6 Permit Type Add Plumbing Fixtures(_Main/_Lower Level)
Septic System
i
—New E Water Turnaround �
Abandonment ? _ -
1 RESIDENTIAL FEES:
$60.00 Water Heater,Water Softener,or Water Heater and Softener(includes State Surcharge)
$60.00 Lawn Irrigation(includes State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment,Water Turnaround*(includes State Surcharge)
"Water Turnaround(add$280.00 if a 314"meter is required)
$115.00 Septic System New(includes County fee and State Surcharge)
i TOTAL FEES$ I
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 locales of underground utilities. www.aopherstateonecall.ord
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' not to start without a permit;that the work will be in
accordance with the approved plan in the case of work which requ' s a review and approval of I ns. i
X �1.
Applicant's Printed Name Applican s Signature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Rough-In Air Test Gas Test Final
Meter Related Items: Meter Size Radio Read Manometer Staff: