4645 Ridge Cliffe Dr
Use BLUE or BLACK Ink
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For Office Use
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~ EaEd P ermit I-I
111. y tot1 ~ I
I Permit Fee: I
3830 Pilot Knob Road I Z i~
Eagan MN 55122 I Date Received: I
Phone: (651) 675-5675
Staff:
Fax: (651) 675-5694 L
INFLOW & INFILTRATION PERMIT APPLICATION
Plumbing / Sewer & Water
Date: Site Address: 19r"
Tenant: 'V I G Z;, Suite M
RESIDENT OWNER Name: Phone: -7/ 3
/
Address / City / Zip:
Name: License#:
Address: ,55 City: i,
CONTRACTOR
State: -All.- Zip: Phone:
Contact:- 1. •j.~~ Email: //A 5 V✓ ~ ~ T C .C9 PLUMBING (Within the building envelope) SEWER & WATER (Outside the building envelope)
TYPE OF WORK Sump Pump Repair Repair
;--Other: _z Other:
DESCRIPTION Description of work:
FEES
$55.00 / Each (includes $5.00 State Surcharge) TOTAL FEE $
*Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit 1/1 repair costs for
reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors
can be found by visiting www.citvofeacian.com/inflow, or City Hall at 3830 Pilot Knob Rd.
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.goi)herstateonecall.org
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
permit; that the work will be in accordance with the approved plan in the case of work ich requir, s a review and approval of plans.
Applicant's Printed Name ' App icant's Signature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: -Under Ground -Rough-In !Final
I
1 1
Permit 1
I l 7 ~ I
Cit of EI Permit Fee: c
3830 Pilot Knob Road / I
Eagan MN 55122 j Date Received:
Phone: (651) 675-5675 t Staff: 1
Fax: (651) 675-5694 I
20og RESIDENTIAL BUILDING PERMIT APPLICATION
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Date 0j'- Site Address: 1-1161-f-t
Tenant: Suite
RESIDENT I OWNER Name:2 hone:
Address LCity lZip:
Applicant is: Owner , Contractor
TYPE OF WORK Description of work:
Construction Cost: Multi-Family Building: (Yes / No
CONTRACTOR Name: !°~~CCIn~'"c License "3
Address:
City: /T'o State: Zip: 5 S lJ
Phone: fZ-~/~T Contact Person: rJ
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Category 1 Minnesota Rules 7672
Energy Code . Residential; Ventilation Category 1 Worksheet New Energy Code Worksheet
Category Submitted Submitted
submission type) Energy Envelope Calculations Submitted
In the last 12 months, has the City of 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: Phones
Sewer & Water Contractor: Phone:
NOTE: Plans' nd supporting documents that you submit are considered to be public information. Portions "of
the information may be classified as non-public if you ode specific reasons that would permit the:CJ'ty to
conclude that fh de_secrets.
1 hereby acknowledge that this information is complete and accurate; that will be in confomnance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a pft, and work is no Yo start without a permit: that the work will be in
accordance with the approved plan to the case of work which requires a review ansapproial of pla
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Applicant's Printed Name A ants Signature
Page 1 of 3
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~ C. R. Vi/INDEN & ASSOCIATES, INC..
LAND SURVEYORS TsL 646-3646
For 1381 EUSTIS ST., ST. PAUL, MINN, 55108
:
U. S Home Corporation `7 yS ZloyC C1 U(-
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f Note; As of this date Johnny
Cake Ridge Third Addition
has not been recorded.
Lots 1 through 4 inclusive, Block 1,
Johnny Cake Ridge Third Addition,
Dakota County, Minnesota
WE HEREBY CERTIFY THAT THIS I A TRUE AN A
5 D CORRECT REPRESENTATION OF SURVEY OF THE
BOUNDARIES OF THE LAND ABOVE DESCRIBED AND OF THE LOCATION OF All BUILDINGS, IF ANY,
THEREON, AND ALL VISIBLE ENCROACHMENTS, IF ANY, FROM OR ON SAID LAND.
Dated this 83 day of ~UT _A. D. 198p C. R. WINDEN & ASSOCIATES, INC.
by
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Surveyor, Min"sota Registration NO-22 ei
CITY -OF EAGAN WATER SERVICE PERMIT
3795 Pilot Knob Road PERMIT NO.:
Eagan, MN 55122 DATE:
Zoning: No. of Units:
Owner _
Address: j
Site Address:
Plumber:
Meter No.: Connection Charge:
Size: Account Deposit:
Reader No.: Permit Fee: I
1 agree to comply with the City of Eagan Surcharge:
OrdAof . Misc. Charges:
Total:
By Date Paid:
Date Ins Q~. Insp.:
CITY of EAGAN SEWER ;SERVICE PERMIT
3795 Pilot Knob Road PERMIT NO.:
Eagan,' MN 55122 DATE:
Zoning: No. of Units:
Owner:
Address:
Site Address:
Plumber.
1 agree to comply with the City of Eagan Connection Charge:
Ordinances. Account Deposit:
Permit Fee:
Surcharge:
BY Misc. Charges:
Date of Insp.: Total:
Insp.: Date Paid:
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3830 P�iof Knob Road ;
Eagan RAN 55122 � Date Receroe�d: j
Phone:(651)675-5675 � �
Fax:(651 j 6T5-5694 1 Staff: t
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. . . . . . � . . .t���.�....... �.���.�.�..���J�
2014 RESIDENTIAL BUIL.�31NG PERMIT APPLICATIBN
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Date:�'���'"j� Site Addre.ss: L['��/�'" � �/ 7 �� �iG Ci,r/��` ElnFt#'
� tVame: ��/�i1� �-r�'�� t t�t,.�r��?�+�r� �Phone:
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C1W1��F Address I City f�ip: ���"�' /��� ,
Applicant is: Owner � Gantractor
Description of work: ��r�r �(�� �{ ��- ---J'�o�'/"��
TYt�+a of WoMC �
Cons#ruction Cost:������ Mu�i-Family Building:(Yes�/No�
Company;I VC�I��1°5� �r�Y11�v9�C.�U15 '� Cor�taact t l f� �G�tJ��'
� Go�tra�t�r �daress:�5'��� �✓���`��ja�r- L,%�-y}x /� c;�,:���'� �f�t�l.��
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State_�Zip:� Phone: ` Emai1:��►rn�? t3v'L�_,;'..,..5'T��r�t�J`�✓�v�vv —
trcense#: �J� �.r�S� �'1 7� -_�c. �_�-�.
l.e�aa certif[cate#:!V�.t—.—r�i�1 t9 3 ~-�
It the pro}ect is exempt from lead certi#°�cation, please exptain why: (see Page 3 for addition�it informatian)
CflMPLETE THIS AREA ONLY IF CONSTRUCT'ING A NEW BUILDtNG
)n the last 12 roont , a�the City of Eagan iss�d a�rmit€or a similar plan based on a ma�#er plan7 `
^Yes _No if yes,date and addr master p[an:
Ucensed Plumber: Phone:
Mlechanicai Contractor: ,
Sewer 8 Water Con r; Phone:
�OfE= �a�d syppof#in�'docu�n�nfs fl!rat yc�rt sutimit�r�caasideF�c!f4 L�e publhc in�rrn�#an ��rti�ns of
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trtfQrmatiet�m��rb��la�si�ed&s nart pubiic ifyot�pr+ovid'e.spec�c r�s�trs�lr�t t�r�ittfd{�ei�►rtt:��G��,r#t>
c��rcf�de#tr�=f�ie �r��ad�secc�ts.
CAL�BEFORE YOU D1G. Cait GophrerSta�One Ca8 at(651}454-00pZ#arprotection agai�st undergrounci ut�lity damage. CaA 48 hours
beiore you iRtend to dig to receive locate.s of underground utilities. ww�v.c�opherstateonecait.oru
i hereby acknowledge that this irifarmation is t:ompiete ar�d ac�urate;that the vaork wlit be in t:onfwmance with the ordinan�ar�tl codes of it►e Giry of
Eagan; #hat 1 uadersfand this is not a permit,but only an applic�tron#or a permit, and w�ork is not to start writhcwt a permit;that the work will be in
accordance writh Ute appraved pfan in the rase oi u�rorlc wk►ich requires a review arxt approvat of plans.
Exterior�nrork authairized by a building pemvit issued in acc�dance with the Minnesota State iiding Code must be compieted witt►in 180
days of}�rmit issuance. '
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Applir.anf's P�r�ted Name anY's Signature
Pi�f of 3
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA176283
Date Issued:05/10/2022
Permit Category:ePermit
Site Address: 4645 Ridge Cliffe Dr
Lot:4 Block: 01 Addition: Johnny Cake Ridge 3rd
PID:10-39802-01-040
Use:
Description:
Sub Type:Water Heater
Work Type:Replace
Description:Standard Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Thomas Harwood
4645 Ridge Cliff Dr
Eagan MN 55122
Genz Ryan Plumbing & Heating
2200 West Highway 13
Burnsville MN 55337
(952) 767-1000
Applicant/Permitee: Signature Issued By: Signature