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1000 Blue Gentian Cir07/15/2t A 15:01 FA% City of Eaian 3630 Piiot Knab Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Q002 ?------.-__.--_......- I For dtf?ce:'?'s.? ? I ? ? PermR #: v? 1 ? ? TT- 1 Permit Fee: I ? ? Date Received: ( i i staff: _ i L _ -- - - - - - - - - - - - - - - _ 2008 RESIDENTIAL PLUMBiNG PERIIAtT APPLICATl4N Date' '7- / 7J 02 Site Address• ?A-?i "?'il <'i Tenant: Suite #: RE8(DENT ! OWNER Name: 44 14 K u G? Phone: Address ! Ciry / Zip: CONTRACTOR Name: License #: Rddress? ff ? City: I ! r?t QState: 0? 14 Z[p: S'ro 8? Phona: 5-(-2 Contact Person: &01 !4'z/1_ e?-- TYPE oF woRK ..? New _, Replacement _ Repair - RebuiVd _ ModNy Space _ Wot1c in R.O.W. Descrl tlon of work: PERMIT TYPE RESIDENTIAL Water Heater Water Softener l.awn Irrigation Add f'lumbing Fixtures ? RPZ /_ PVB) ? Main _ Lower Level) v Septic Syslem Water 7umaround w Abandonment RES/DENTIAI. FEES: $60.50 Minium Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge) $30.50 Lawn Irrigation (inciudes $.50 State Surcharge) $50.50 Add Piumbing Fixtures, Septic System Abandanmenx, Water Turnaround` (inciudes $40 State Surcharge) "Water Turnaround (add $136.00 if a 5l8" meter is requlred) $100.60 SeptlC SyStem New ($10.00 per as built) (inciudes Caunty fee and $.50 State Surcharge) $50.50 Fit'e Repair (replace bumed out apptiances, ductwork, etc.) (fncludes $:50 State Surcharge) ? o TOTAL FEES S I hereby acknowledpe that this Information is complete and accurate; that the work will 4e 1n oonrortnance wan me oremances ana cvaes or inr %,Pry vi Eagfln; that I understand this 16 not a permit, but only en appliCStlon tor a permit, and worlc 19 not to start without e lk thai the work will be in accordsncs wiM the approved•plan in the caae of work whleh requlres a review and appropl of plans. x U/ A--V A, 6- ?F; /t ? Applicant' PHnEed Na e . FOR OFFICE U3E Appltcant's Reviewed By: Date: Requlred Inspectians: ._Under Ground __Raugh-In ,_Air Test _,Gas Test _Final City of Eap 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 - ----------- i ? ?o:r?raffiee l1's'? I ? j Permit #: i Permit Fee: 4?0. ? I ? ? Date Received: ? I ? I Staff: ? I ----------------- 2008 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Daie: C-) Site Address: /d oo 6CK TiGCt1 ? ?.{ Q!1 Tenant: ?aGa viSuite #: ? RESIDENT / OWNER Name: ov?4121k'irirc.°s Phone: s k /?? ?j?-? Address / City / Zip; o? ? 3 1; r L?? ? 1`!J ? S?•r?'? t?-? ? Applicant is: ?-6avrrer ? Contractor K OP/?IB???Q/t TYPE OF WOR Description of work: Construction Cost: Multi-Family Building: (Yes No X-) CONTRACTOR i-/ Name: ?r? Tq ?/?eean- r' License #: Address: r \.r )i?4604St : /;" Zi t p e: ! a City: Phone: 057 73 5 a- Contact Person: WaF' /? G' COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING _ Minnesota Rules 7670 Cate ory 1 Minnesota Rules 7672 Energy Code . Residential Ventilation Category 1 Worksheet :• New Energy Code Worksheet C8tBg01'y Submitted Submitted (q submission type) • Energy Envelope Calculations Submitted ? In the last 12 monihs, has the City ot 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: ` NOTE. P, lans and supp,orting, tlacuments ihat you subr"iai[ are constdered to be publi.c informat?on:.° Portions af ;:;': '`the Informatfon may 6e classif?ed a? non publrc If you provide;`speciftc reasons that would permit the City,to ?onclude"that the a're tra'de secrets,.'; :' .. , I hereby acknowledge that this intormation is complete and accurate; that the work wili be in conformance with the ordinances and codes oT the City of Eagan; that i understand this is not a permit, but only an application tor a permit, and work is not to start without a permit; that ihe work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. X X Applicant's Printed Name Applicant's Signatur Page 1 of 3