2910 Burnside AveCity of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 2910 Burnside Ave
Lot: 1 Block: 3 Addition: Country Home Heights
PID:10- 18300 - 010 -03
Use:
Description:
Sub Type: e- Windows/Doors
Work Type: Windows/Doors - New/Replacement
Description: House
Census Code: 434 -
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 3,000.00
Contractor:
Flannery Construction
1375 St. Anthony Avenue
St. Paul MN 55104
(651) 225-1105
PERMIT
City of Eaan
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
Applicant/Permitee: Signature
- Applicant -
Construction Type:
Occupancy:
Carbon monoxide detectors are required by law in ALL single family homes.
Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing
inspection. Call for final inspection after installation.
$88.50
$1.50
Total: $90.00
Owner:
Jerome Johnson
2910 Burnside Ave
St Paul MN 55121
Permit Type:
Permit Number:
Date Issued:
Permit Category:
0801
9001
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply
of Minnesota Statutes and City of Eagan Ordinances.
h all applicable State
Issued By: Signature
Building
EA088799
04/21/2009
ePermit
CITY OF EAGAN
3795 PilW Ksob Rood Eeyan, AAN s5122
PHONE: 454-8100
BUILDING PERMIT
Receipt #
Te be awd fee Est. Vclue . Dote , 19
Site /lddrcss E?ect ? Occuponcy
Lot Block Sec/Sub. - y. ,- 'AIter p Zoning
Parcel # , Repoir '?
Enlarge ?
W Name Move 0
; Address , Demolisfi ?
b
Ci phoM •- Grode ?
oe Name Approrols
? pu Address .. .- ', ' Assessment _
o6,...._ Woter a Sew.
Name _
Address
Pol ice
Firo
Enp.
Plartner
Council
1 hereby acknowledge thot I have reod this opplicotion and stote thot Bldp. Off.
the inlormotion is torrect ond ogree to comply with oll opplicOble ?PC -
Sfate of Minnesota Statutes ond Gty of Eoqan Ordirances.
Sipnoture of Permittee
Fire Zone
Type of Const.
# Stories _
Length
Ft.
Permit
Surctwr9e
Plan check
SAC
Woter Conn.
Woter Meter
Rood Unit
Totol
A Building Pertnit Is issued to: on the express condition that
all woric sFwll be done in xcordonce with all opplioabk Stafe of Minnesoto Statutes ond City of Eeqen Ordinances.
Bufld{np Offlciol
Permit No. Permit Holder Misc. Permit No. Holder
Plumbiny
H.V.A.C. Qt..c? V1 ? C? J-ZS-
Wall
Water
Disp.
Sawer
Eketric p C.i, 12? r -ZS 4Z
fr
Inspection Date Insp. Other
Footinqs
Foundatlon
Freminq
Rouph PI6y,
Rouph HVA
Inwlation
Firul Plbg
Final HVAC
Final
yyater DescriM Location:
YWII
Sewer
Pr. Disp.
Reoeipt --?
PLUMBING PERMIT Permit No.
CITY OF EAGAN
Fee
fi!l in numbered spaces S/C
Type or Print /egib/y Tot. ?
1. Date 2. Installation Cost
3 ?
. Job Address Lot
Blk. Tract
4. Owner
5, Contractor - ' Phone
6. Address
7. City State 2ip
8. Building Type: Residential Commercial O Institutional ?
9. Work Description: New ? Add O Alter ? Repair•k
10. Describe
11.
No. Fixtures
Water Closet No. Fixtures
Cess
o
i
fi
l/D
ld
Bath tubs p
o
ra
n
e
Se
tic Tank
Lavatory p
Softner
Shower Wel I
Kitchen Sink
Urinal/Bidet Oiher
Laundry Tray
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed :
for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 464-6100
-s..?
_i
Receipt ' MECHANICAI PERMIT Permit No. CITY OF EAGAN
Fee
Fill in numbered spaces S/C
Typs or Print Jegib/y Tot.
t. Date 2. InsWllation Cost
3. Job Address r Lot ? Blk. Tract
4. Owner
5. Contractor ' - ' --'-' -"" Phone
6. Address
7. CitY
State ,
ZiP
8. Building Type: Residential '§!? Commercial O Institutional ?
? 9. Work Description: New O Add ? Alter O Repair k
10. Describe
11.
uel Type
No. Equi{?ment 8TU - M. Ea.
Forced Air No. Euuipment CFM
Ai
dli
H
Mfg. r
an
ng:
Boilers
Mfg. Mech. Exhaust
Unit Heater
Mfg. Other
Air Cond.
Mfg.
Gas, Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-6100
CITY OF EAGAN Remarks
,,,,,,;,;,,,, Country Home Heights . 1 3 10 18300 010 03
State Eagan, MN 55121
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK 1968 • .33 30 PAID
SEWERLATERAL , 72 2143.75 107.19 20
WATERMAIN
?F WATER LATERAL & Stu 1972 ? 20
WATER AREA n
STORM SEW TRK 1984 495.00 33.00 15
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 300. 00 5524 3-27-72
BUILOING PEF. 20 117 3-67
sac 5524 3-27-72
PARK
;
z
BUILDING PERMIT
N? 7043
Receipt #
Te be wed fer FIE2E REPAIR Esf. Volue $20.000 Date_ rA-rym}wr 9R , 19JI1_
Site Address 2910 Burnside Avenue Erect ? Occuponcy R-3
Lot 1 Bixk 3 Sec/Sub. CbtlntrY HOM fle19htJdter ? Zoning R-1
10 i 8300 010 03 Repoir XX Fire Zone NA
Parcel #
l
E t
T
f C Vn
arge
n ? ons
.
ype o
rc Name J2.Txm JOI7i1SOI1 Move ? # Stories
; Address 2910 Bi1ri151de AVenUE - Demolish ? LengthN&
b
Ci Erlgan 55121 phone 454-3005 Gmde ? Depth--N?-_Sq. Ft.-
? Name Rill RYIIPS'*1P ApProrols Fees
a
?? llddren 3729 Pilot Ki1ob FdUad
? P.... Faean 55122 e?___
Name _
Addrese
1 hereby acknowledge thot I have reod rhis applicotion ond state that
fhe iniormafion is correct and ogree to comply with all ap0licabla
$fate af Minnewta Statutes and Ciry of Eogon Ordirances.
Sipncture of Pertnittee
A Building Permie Is issued to: R?
all work sholl be done in accordance wlth all
Buflding Officiol
CITY OF EAGAN
9793 Pllae Knob Road Eegan, MN SS122
PHON[s 451-8100
Assessmenl _
Water 8 Sew.
Police -
Fire
Enp.
Planner -
Council _
Bldg. Off. _
APC -
Permit 14o.7V
Surchorge 10.50
Plan theck NA
SAC im
Wafer Conn. NA-
Woter MeterNA, -
Road Unit NA
Tot,i $157_!1(1
on tha ezpress conditian thni
of M{ nesQip Mutes and Ciry of Eagon Ordirwntes.
r?
?.? ik 77 G? CITy pF FAGAN Include 2 sets of plans,
1 site plan w/elevations &
BUILDING PERNIIT APPLICATION 1 set of energy calculations.
7b Be Used For c'- "Valuation Date
Site Address `O OFFICE USE ONLY
i,ot ? Block ?- Sec./Sub. C?f?P- ? -3
Erect Occupancy
Parcel #: 10 l?-?-0 ?? C9 tU Alter zoning
f Repairi - Fire Zone
osmer: Enlar5e _TyAe of Const.
Address: M°ve # Stories ft.
?, Deirolish Front
City/Zip Caie: C?-*O-r\, SS? 2- ? Grade Depth ' ft.
Phone #: y s q3 rp S
FEEs
Contractor: &0-1, ?A'f STG?
AddmSS: 37 t y r- VH NoR v,
citY/zip coae: Z-Z-
Phone #:
Arch./Eng..
Address:
City/Zip Cocle:
Phone #:
APPROVAIS
Assessnnents
Pexmi t
Water/Seaer Surcharge
Police Plan Check
Fire SAC
glq, Water Conn. &14_
Planner Water Meter .OrA
Council _ Road Unit 41^
Bldg.
APC
TO7'AL ?f? `
EAGAN TOWNSHIP
BUILDING PERMIT
Owner ...........\!f.!!ncrn.'.`.-?....?....-----------'--
O q ?
Address (Present) .... °t:.[_L.G..._..'. .. ......".' ..................._.._ k?
Builder ---------- /?..':?. ?....... Q3-" ."."' ° ..'.
.......-- ............._ ..
Addrese ......---_........-------------------- ............................
DESCRIPTION
N? 1539
Eagan Township
Town Hall
Dafe ...... !_.....r?G 7...- ..............
Siories To Be Used For Froni Depfh Heigh! Esf. CoaS Permi! Fee Aamarks
,ac=cc?C.-z`??-
LOCATION
SSreef, Road or oiher Descripiion of Locafion _I Lof Black ' Addifion or Trac!
*?? /,r-? .
This permif does not auihorize the use of siseeis, soads, alleys or sidewalks nor does it give the owner or his agenf
the righifo ereafe anp siiua}ion which is a nuisance or whieh presenis a hazard !o the hea]!h, safefp, eonvenienee and
ganeral welfare 1o anpone in the eommuniip.
THIS PERMIT MUST BE KEPT ON HE PREMISE WHILE THE WORK IS IN PAOGR S? S.
This ia !o cerlify, ihal..... ,......'- -" .............. ....'-.'-_............... has permission !o erec2 :?'""? /- q}?------.--.. -.•-- - upon
the above deseribed pree su jee! to the provisions of the Building Ordinanee for Eagan Town ip aAh doppzil 11,
1955. /J?
-_"'-"""-"---......--'......:'....._".`r_.Y....?.._-.."?....---. Per ........_............ Gl.?+-ea.o......-- ........
..............
of Tnwn Board 4 , B ?? r Bildin Ina ector ?
Thig reqaest void
13
1e n,7=16.?6
CLI 1 B3, I?r,? . 4o<-A_(` fWi. t.?$Sq W
sD,vl
Reques[ Dete
I ?_??, ?? Fire No. Rouqh-in Insoeciinn
9 ireA?
? -
?V?;s No ,?./
?Readv Now ?gWilil ins
pec'
l N ot v.
? 1or When qeadY_
C] Licensed Electticnl Contractor I herehyrequest inspection of a6ova
0 Owfier electncal work installad at
Street Address, Bou m Route Na. City
tv /JnU ??? ? ??TO4?
aclion o. Townshiv Name or No. Ranpe. No. County
I7 Nv
pecupnnt IPflWTI Phone No,
sF? o?,? sa s,,. ys y- 3? 6
Powe{ Suoolier Address
??
EIG
?f?n
cul Con
trec
ror
(Cumpany Name) Cuntractnr"s License No.
(
?
]
?
^
l./
Mailir4q AtlJress I
ConVacto, or Owner Makinq Instailatinnl _
p
µ.rv\- `/
Authorized SiNnature (Cnntractor/Owner Makinq Installation) Phone Numbe.r?NNESOTA STAd£ BOAflD OF ELECTRICITY TMIS INSPECTION REQUEST WILL NOT
Griggs-Midwav Blde. - Noom N-191 ' BE' ACCEPTED BY THE STATE eOABD
1821 UniversitV Ave.. St. Paul, MN 55104 UNLESS PFOPEfl INSPECTION FEE IS
Phnnw 18121297-2111 ENCLOSED.
/? ';REQUEST FOR ELECTRICAL INSPECTION
p? ??, Seo instructions (or completing this form on bnck ot yellow copv.
V
" Below Work Covered by This Request
EB-00001-03
Nev, Atld flep. Type of Builtling Applinnces Wiretl Equipment Wired
Home Ranye Temporary Service
Duplex Water Heater Lighting Fixtures
Apt. Buildfng Dryer Electric Heatiii
Commercial Bldy. Fumace Silo Unloader
Indusb'ial Bldg. Air Conditioner Bulk Miik Tank
Farm Othe.r peci v ?M1e? ISnecifyl
thnr ISUecilY Othoi Othiqr
Compute Inspection Fee Belaw
N Fee ServiceEnhance$ize k Pe.e Feeders/Subieedars N Fea Circaits
? O ? 0to 100 qm 0s 0 to 30 Am ps 45,100 0 to 30 Am s
101 to 200 Amps 31 to 100 Amps 31 to 700 Am
Above 2D0 Amps Above 100_Amps Ahove 100_Am)s
Transrormers Remote Control Circ. Partial%Other F e
Signs Special InsPection S 'G'tl ;?
Feirvarks
i TOTAL FEE ?j0.
J
Roueh-in Da?e
?
j ?/?-J` 1,the Bechieal
Inspector, Iiereby
certify that the above
inspectiOn has been
C --?; j made.
This request voitl
1 a mmo Ns hortr
Thia request void
?$' 7664
RP.quCSt Uate Fire No. flouPi?-i0 InsPeclion
Feqv ?e.d?
?Reatlv Now [] Will NoGfy.lns
peo
?
..._ ?y
?s to
r When Rr,udY
n Licensed Eleculcal CunVar.tor I hereA re ' y quest mspec[ion ol above
kwner electrical work installed at:
SVeet Address, 6ox or Rnute No.
]? 1 r
S
/
'
7 Ciry
?
°1
C c
i?v? t
!.'
Ji,LI- 1
\
eciwn o.
• Township N,?me or No. ftange. Nn. Counly
Ixt-i/ _\'?../j
??(JT`
Occopunt (PflINT)
i:li`cyN?? 3c? ? rv SV ? Phonc Nc.
? ?`a ? -3GL!??
Power $voPlier
? 1 C .T
J Aadress
Etectrical ConVac[or
(C
omuuny Nxme) ' Cnntrar.me's License No.
{
?
?.{.?
Mailing AAJress (Con[ractor or Owner Mokinu Instailation)
AWhonze.d Sfgnature (COntr tor/Owner Makine Installatiurd Phiinc Nmnber
NNESOTA STAT AqD OF ELECTRICITY ' .. THIS INSPECTION REQUEST WILL NOT
iggs-Mid'wey Bldg. - Noom Nd91 ' BE ACCEPTED BV THf STATE BOARO '
1621 University Ave., St. Paul, MN 55704 .. ' . UNLESS PflOPEN INSVECTION FEE IS
Phona 1612) 297-2111 ENCLOSEO.
^ AREQUEST FOR ELECTRICAL INSPECTION EB-00001-03
T i 7' I1. v •r O y? /?/ See instructions lor completing this form on bnck of Velluw cnpy. ,?'"X" Below Work Covered by Ihrs Request -:2 ; r.?s q l (O
Ne AAd Rep. Type oi Builtling AoPlfances Wired Equipment Wired
Home Ranye Temporary Service
Duplex Water Hcater Lightiny Fixtures
Apt. Building Dryer Electric Heatin
Commercfal Bldy. Fumace Sllo Unloader
Industrial Bldg. Air Conciitioner Bulk Miik Tank
f-arm ??t", .tle"iW otne, 1SUer:ifv1
ihe r Sueci v. Other pther
Conrpute lnsper,tion Fee Below d Pee SarviceEntranceSize U Frte Feede,s/SUblexAers # Fca Circvits
Q100 0 to 100 qm s 0 to 30 Am>s 0 to 30 Am s
101 to 200 qmps 31 to 100 qinps 31 to 100 Am s
Above 200 qmps A6ave 100_Amps Above 100_Amps
Transtormers Remote Control Circ. '.? P rtial%Other Fee
Signs
Special Inspection ,
T
A
o
R??narks OT
L FE JO.
J
. J
Rough-fn Date
?, ihe Elechical
Inspector, hereby
tif
th
h
Fin;il cer
y
at t
e »bove
inspectionhasbeen
__ - ..? _ ._.7 °? _ •.% metle.
Thls request voi,1
18 nionths from
2007 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone 9 651-675-5675 FAX # 651-675-5694
New ConsWction Reouirements
3 registered site surveys showing sq. ft. of fot, sq, ft. of house; and all roofed areas
(20 k macimum bt coveraqe aliowed)
1 Soils Report if proposed building is to 6e placed on disNrbed soil
2 copies af plan shovnrg 6eam & window sizes; poured found design, etc
1 set of Energy Calaiafions
3 copies of Tree Preservatian Plan if IM platted aRer 711193
Rim Joist Oetaii Opfions selec6on sheet (buildings with 3 or less unit)
Minnegasco mechanical venGlation fortn
Telephone #(
Plans are considered pu6lic informafiion unless vou state they are trade secret and the reason.
Date ;7 Constructian Cost
Site Address `e AIV-t Unit/Ste #
?
r
Descriptiou of Work Zy f? Uf?
Multi-Family Bldg _ Y_ N Fireplace(s) _ 0 _ 1 _ 2
? ?
?J
Property Owner ? Telephone #
( )
/,/'v ?((
-?
I
Cantractor P/ C O its?/?c.e.7`•-? ?
Address T( '/
DO City Ah
State Zip 6`?V? Telephone # ( )
COMPLETE THIS AREA ONLY IF CONSTitUCTING A NEW BUILDING
- Minnesota Rules 7670 Catesorv 1 _ Minnesota Rules 7672
Energy Code Category , Residential Ventilation Calegory 1 Worksheet • New Energy Code Wor9csheet
(Jsubmissiontype) Submitted Su6mitted
. Energy Envelope Calculations Submittetl
In ihe last 12 mon}hs, has the CiTy of Eagan issued a permit for a similar plan based on a master plan?
! Y. _ 4d if yes, date and address of master plan:
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
I herebY apply for a Res
Telephone #(
Telephone # (
On-siteSeptlcSystem _Y _N
Permit and acknowledge that the information is complete and accurat
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 a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
Lof.l?s.,? ?E?1-A??--?-.
Applicant Printed Name
9? 15?6
RemodellReoair Reauirements Oifice Use Oniv
2 copies of plan shovnng foofings, beams, joists Cert of Survey Recd _ Y _ N
7 setof Energy Calculations forhealed addifions Sals Report Y _ N
i site survey for additions & decks Tree PreS PladRecd Y _ N,
Add"Aion - indicate iloasife sepfic sysfem Tree Pres Required Y _ N
i ?
App ic t ignaCure
,
EAGPN 1UWNSHIP
3795 Pilot Knoh Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR WATER SERVICE CONNECTION
Date: March 27, 1972 Number: 797 J-3 Gf/?Billing Name: Jerame H. Johnson
Owner: same
Site Address: 2910 Burnside Ave., Eagan 55121
Billing tlddress
Plumber• Weier)Rke Trenching & Excavating
Met/er Size-? " Coanection Chg. 300.00 pd 3/27/72
Meter No??G9?1?a? Permit Fee ,??'• °'" ?a=/•?.:i
Meter Reading f Meter Dep. 15.00 pd 3/27I72
Meter Sealed: Yea_ IAdd'1 Chg.
NO [Total Chg.
Building is a:
Residence xx
P4ultipie No,
Commercial
Iadustrial
Other
Inspected bq
Date
Remarks;
?,r ?, - •.. . ; ? ._ .
I. . _
Sy:
Chief Iaspector
In consideration of the issue and delivery to me o£ the above permit, I
hereby agree to do the pxoposed work in accordance with the rules aad
regnlations of Eagan Township, Dakota County„ Minnesota.
Sy:
,
?
Please notify the above office when ready for iss..pection and connectlon.
EAGEN TOWNSHIP
3795 Pilot Krtob Road
SL. Paul, Minnesota 55111
Telephone 454-5242
PSRMIT FOR SEWER SERVICB CONNECTION
DATE: March 27, 1972 N[1MBER 9q9
r?
OWNER: Jerome H. Johnson ,gddress 2910 Burnside Ave., Eagan55721
pLUMBER Weier*e Trenching & F,xcavafiffi OF PTPE Heavy Catt Iron
AESCRIPTION OF BUILDING
Industriall Commerciail Residential I Multiple Dwelling f No, of units
xx
Location of Connectiona:
Connection Charge 260.00 pd 3/27/72
Acct. Dep. 75.00 pd 3I27/72
Permit Fee
Street Repairs
Total
Inspected by:
DaCe
Remarka:
Sy
Chief Inspector
In consideration oF the issue aad delivery to me of the above permit, I
hereby agree Co do the proposed work in accordance with the rules and
regulations of &agan Toc•mship, Dakota County, Minneaota
By_ry??i?
Please notify when ready for.inspection and cosu?ection and before any portion
of the work is covered.
,lot
For Office Use
a~ I Permit#: I lty of Ea
Permit Fee:
6 .d
3830 Pilot Knob Road
I
Eagan MN 55122 i Date Received: MAR 13 2009
Phone: (651) 675-5675
Fax: (651) 675-5694 Staff:
- - - - - - - - -
2008 MECHANICAL PERMIT APPLICATION
Date: Site Address: aq ~1~f18t ~V t
Tenant: Suite
RESIDENT / OWNER Name: 2pkor\, a- 4 Serom Ip_lrlSoYn Phone: (oS 30oS
Address / City/Zip: 9A l0 ~v?rr15~ ~v e Ea- Ck» m P3 SS 12
CONTRACTOR Name: CENTERPOINT ENERGY License
Address: 9320 EVERGREEN BLVD SUITE B
City: COON RAPIDS State: MN zip: 55433
Phone: 763-757-6202 Contact Person: JOANN ZINKEN
TYPE OF WORK New Replacement Additional Alteration Demolition
Description of work: S"S_ a t\ i e i rt _ a. p .t
NOTE: Both roof mounted and ground mounted mechanical equipment is required to
be screened by City Code. Please contact the Mechanical Inspector or one of the
Planners for information on permitted screening methods.
PERMIT TYPE RESIDENTIAL COMMERCIAL
Furnace New Construction Interior Improvement
?r Conditioner Install Piping Processed
Air Exchanger Gas Exterior HVAC Unit
* HVAC units must be screened
Heat Pump r _ Under / Above ground Tank Install / - Remove)
'Other LX t wor When installing/removing tank(s), call for inspection by Fire
Marshal and Plumbing Inspector
RESIDENTIAL FEES:
$50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge)
$90.50 Fire repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge)
$ TOTAL FEE
COMMERCIAL FEES:
$70.50 Underground tank installation/removal OR Contract Value $ x 1%
$50.50 Minimum (includes State Surcharge)
Permit Fee
- If Permit Fee is less than $1,000, surcharge is $.50.
If Permit Fee is > $1,000, surcharge increases by $.50 for each State Surcharge
$1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 surcharge).
$ TOTAL FEE
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 witho t a permit; that the work will be in accorda ce with the approved
plan in the case of work which requires a review and approval of plans.
x JOANN ZINKEN x
Applicant's Printed Name A licant's Signature
FOR OFFICE USE I eviewed By: Date:
Required Inspections: -Under Ground - Rough In Air Test -Gas Service Test In-floor Heat -Final
For Office Use
' ter'-- tOl 7
rry� nYraY` E AGA N
Permit#:
Yw•w" r/I
Permit Fee: (0 67 -ad
Date Received:
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651)675-5675 I TDD: (651)454-8535 I FAX:(651)675-5694 Staff:
buildinginspectionsCa?cityofeagan.com J
2019 RESIDENTIAL
PLUMBING PER IT APPLICATIONf
_ 1 9410 r s_d-c-M ss-
Date I Site Address �V
_Tenant: *0711:4
� Ng`� """ . '' f,, Suite#: �QF2esident/O .7- -, ! Name: �CI pk- Phone:6bl v d, IJ fU
{ f � ;i1:
Address/City/Zip: P- I1 0eobi-P(4.4. friN-R---/
, ktr .11;c
Name: MILBERT COMPANY dba CULLIGAN WATER License#: WC641376
Contractor.
Address: 1801 50TH STREET EAST City: INVER GROVE HEIGHTS
State: MN Zip: 55077 Phone: 651-451-2241
Contact: BILL MILBERT Email: gloria.abas@culligan4water.com
Type of Work
—New Replacement i Repair ^Rebuild _Modify Space _Work in R.O.W.
Description of work:
Water Heater
Lawn Irrigation( RPZ/ PVB):
y Water Softener
DeScrlption Add Plumbing Fixtures( Main/_Lower Level)
—Septic System
Description:
New
Connection to City Water from Well
Abandonment --
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 New fixtures, adding or removing piping(includes State Surcharge)
$60.00 Septic System Abandonment
$100.00 New Residential (fee collected with Building Permit)
$115.00 New Septic System (includes County fee and State Surcharge)
$60.00 Connecting to City Water from Well* +$290 for Meter and$190 for Radio Read =$540
*Sewer&Water Permit also required for connection charges
60.00
TOTAL FEES
CALL BEFORE YOU DIG. Call Gopher State Ono 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,gopherstateonecail.ory
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.cityofeauan.comfsubscribo.
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
♦ agan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
acco dance wi h the approved n In e ca of work wh' h requires a.review and approv I of pl•ns.
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Applicant's Printed Name Applicant's Signature
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