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