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2600 Lone Oak Pkwy - SW Disconnect Permit Use BLUE or BLACK Ink r For Office Use I l Cityof Cj Ea a( Permit#: 15 13 � Permit Fee: (0 �� 3830 Pilot Knob Road Date Received: Eagan MN 55122 Phone:(651)675-5675 Fax:(651)675-5694 Staff: J 2017 SEWER AND WATER REPAIR / DISCONNECT PERMIT l Date. 7/18/2017 Fee. $65.00 City Sewer City Water Repair ✓ Disconnect Description Of Work: Disconnect the water and the sewer from the old Delta Head Quarters building To Demo the building Street Address for Propos;70."--kI 1 Lone Oak Pkwy Eagan Name: Frattalone Compaines Phone: 651-248-7637 Owner I3205 Spruce St St Paul, Mn 55117 ; Address/City/zip. P Applicant is: Owner ✓ Contractor i I Licensed Pipelayer ✓ Master Plumber Property Owner I Name: Patrick Skelly Phone: 651-248-7637 Address,�;ty,Z;p: i 3205 Spruce St ST Paul, MN 55117 Pipelayer Training Certification Card#: 4347 or Master Plumber License#: I acknowledge that the information is complete and accurate and that the work will be in conformance with the ordinances and codes =. of the City of Eagan and the State of MN Statutes. I understand this is not rmit, but only an application for a permit, and work is not to start without a permit. Patrick Skelly - LppliApplicant(Print Name) A cant's Signature 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.qopherstateonecall.orq