2139 Cliffhill LaneCirY oF EaGnN
3830 Pilai Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHON E: 454-8100
BUILDING PERMIT Receipt#
To be used for . `. .' ... Est. Value Date %- ?-= '19 -
Site Address
Lot ` Block -' Sec/Sub. 4 y "'?"
Parcel No.
w Name
z Addre
3
0 City_
,o Mame
oq Addre
City _
Phone
I hereby acknowledge that I have read this application and state that the
information is correct and agree to comply witJi all applicable State of
Minnesota Statutes and City of Eagan Ordinances.
5ignature of Permittee
A Building Permit is issued to: - '
on the express condition thal all work shall be done i n accordance with al I
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official
O11 5'1t@ S6W8Q@
MWCC System
On Site Well
City Water
PRV Required
Booster Pump
APPROVALS
Engr./Assess. `
Planner _
Council _
BIdg.Off. _
Variance _
II IVV VVti V?\V¦
Occupancy
Zoning
(Actuaq Const
(Allowable)
# of Stories
Length
Depth
S.F. Total
Footprint S.F.
FEES
Permit ,
Surcharge
Plan Review
SAC, City
SAC, MWCC
water Conn.
Water Meter
Road Unit
Treatment P1
Parks `
TOTAL
Permit No. Permit Holder Date Telephone #
Plumbing
H.V.A.C.
Electric
Softener
Inspection Date Insp. COmments
Footings I
Footings II
Foundation
Framing
Roofing
Rough Plbg.
Rough Htg.
Isul,
Fireplace
Final Htg.
Final Plbg.
Bldg. Final
Cert. Occ.
Temp. LP
Deck Ftg.
Deck Final
Well
Pr. Disp.
?
? . CITY OF EAGAN
. • 3795 *ikt KnoS Raod Eogan, MM 55122 PHONEs 454-8100
BUILDING PERMIT
*.. ? ...? ??.
Parcel #
Recetpr #
, f?.
r%_._
Sec/Sub. 1 s t
ac Name " : S W
; /\ddroSS t:hC ,.
b _ _
o Nome
?
u? AddreSS
I hereby acknowledge that I havc read this npplication ond stote that
the inlormotion is torrect cnd ogree to comply with oil applicabte
Stote of Minnesota Statutes and City of Eegnn 4sdiswnces.
Erect ? Occuponcy
Alter ? Zoning
Repair ? Flre Zone
Enlorge ? Type of Const.
Move Q * Stories
Demolish p Length
Grode ? Depth Sq. Ft.
Aaaroralf Fees
Assessment Permir
Water 8 Sew. Surchorge
Police Plon check
Firo S^C
Enp. Water Conn.
Planner Woter Meter
Council Road Unit
Bld9
Off.
.
APC Totcl
Siynoturc of Permittee ?
A Buildin9 Pertnit is issued M:
oll work shcll be done in uccordance with nll opplicable Stcte of Minnesata
9uflding Officfal
n tfie express condiT{on thni
of Eo9an Ordinonces.
Parmit No. Psrmit Holder Misc. Permit Na. Holder
Plumbing Z?K! M?r ?e ?-?.Z -Z
H.V.A.C.
Well
Water
'
Disp.
S?wer
e?sctric t,? l31(o Gt-ev??. ?.(!Y.
Inspection Date Insp. Other -
Footingt ?fs*
Foundation
Framinp .?. C-0
Ib ?
Rouph Plbg. * . ?
Rough HVAC •?•l' ?
Inwlation .? . ?
Final Plb¢ . 0
Final HVAC + .g f(
Final
Water Dowibe Locatfon:
VWII
Sawer a
Pr. Diap.
(gtrtifirtttt uf (Orruptturg
titp of Cagan
llr;rttrtmmt o# Builbing Itcsppr#ina
Tbir Certi ficatt ittutd pxrtrraAt to t& rrqxirearsnts o f Sation 306 o f the Uni f ons BuildiRg
Corle cmifprg thar at Tix rir,e of ir.nramr tbis mmctxre was in corRpliana with tbe va+ioru
ordinanca o f tbt City iregulating building coxnrtrctioR or ujt. For tbe f ollowireg;
?lst
aU: August 12, 19A2
.n,
CITY OF EAGAN Remarks
Addition Cedar Cliff Add11-3nn
4
, I /p l ' ?
Improvement Oate Amount Annual Years Payment Receipt Date
STREETSURF. (Q1 1982 1496.30 299.26 5 1197.04 A011353 8-13-82
STFiEET RESTOR.
GRADING Sy
541.38
108.28
5
324.84
A011353
8-13-82
SAN SEW TRUNK 1973 105.53 7.04 15 , 35.23 A011353 8-13-82
* ,6EWER LATERAL 1524.61
WATERMAIN
iNATER LATERAL 1981
WATER AREA SV 1975 94.97 6.33 15 44.33 A011353 8-13-82
STORM SEW TRK 5 1981 405 9 1 r 243.07 A011353 8-13-82
* STORM SEW LAT 1981
CURB & GUTTER
SIDEWALK
STREET LIGHT
ROAD UNIT
WATER CONN. 420 11
BUILDING PER.
SAC
PARK
ON
" CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
; SITE ADDRESS:
? t ? r tc ???. ?«r? i
; r .,1,1• I 7 I :
PERMIT SUBTYPE:
TYPE OF WORK:
Ri" h1p12K5 r Sy[IING kilO1 iN6 'SOFF i T FACG IA ?, I0014 41TN00iJ
i41{S
F- - ?
? I
j'CORD
PERMIT TYPE:
Permit Number:
Date Issued:
.. 1. - , APPLICANT:
Parmit No. Permit Holder Dab Telephone #
ELECTRIC
PLUMBING
HVAC
InspecUon Data Inap. Comments
FOOTINGS
FOUND
FRAMING
ROOFING y???QQ
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATIN(3
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINRL
CITY OF EAGAN WATER SERVICE PERMIT
3795 PiIQt Knob Road PERMIT NO.:
Eagor., MN 55122 DATE:
Zoning: No, of Units:
Owner. _? r ;- :' }1 : o•-,:• g
Address:
Site Address:
Plumber: `.-
Meter No.: Connection Charge:
S12e' Account De
posit:
Reader No.; Permit Fee:
I a9ree to comply with the Ci17r of Eaqon Surchorge:
Ordinanee& Misc, Chorges:
TotnL•
By D
t
P
id
a
e
n
:
Date of Insp.: ?nsp ;
?
CITY OF EAGAN SEVIIER SERVICE PERMIT
3795 Pilof Knob Rood PERMIT NO.: '
Eaaon; MN 55122 DATE:
Zoning: No. of Units:
Owner:
Address:
Site Address:
Plumber: • ''_„ '' ;.?„ _
: r7 1?•'1 ^rl']'?n? ? . .
1 agroe to caepfy wifh the City ef Eagan
Ordinantes,
By
Date of I nsp.:
I nsp..
Connection Chorge: '
Account Deposit:
Pe?mit Fee:
Surchorge:
Misc. Chorges:
Totof:
Date Poid:
.
%
CITY OF EAGAN
` 3830Filot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
BUILDING
031796
04/16/98
SITE ADDRESS:
2139 CLTFFHII.L LANE
LOT: 1 BLOCK: 2
CEDAR CLIFF
P.I.N.: 10-16600-010-02
DESCRIPTION:
sF {Mrsc.)
CtEPAIR
434 ALT. RESIDENTIAL
cltva
REMARKS:
SIDING ROOFING SOFFIT FASCIA 5TORM WINDOW
FEE SUMMARY:
VALUA7IQN $14,000
Base Fea $212.25
Surcharge $7.00
Total Fee $219.25
i'
CONTRACTOR: - Applicant -- ST. LIC.OWNER:
GREAT LAKES WINDOW & SIDE 16913400 20060A27 CHILDS CINpY
6098 LOWER 161ST 57 2139 CLIFFHILL LN
ROSEMOUNT MN 55068 EA6AN MN 55122
(612) 891-3400 (612)452-7022 ,
APPLICANT/PERMITEE SIGNATURE
ermit Type
grk Type
?tt?iti ?.9ir? f rY4t?
ISSUED Y: GNA RE
31146 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL) Z.Jr
CITY OF EA(}AN
3830 PII.OT KNOB RD - 65122
681-4675
New Construdion Requirements
? 3 registared sRe surveys
? 2 copies of plans (inGude beam & window s¢es; poured fnd. design; etc.)
? 1 energy ealculations
? 3 copies of tree preservation plan H lot piatted after 711/93
required: _ Yes _ No
DATE: y /3- 'F f
DESCRIPTION OF WORK:
RemodeUReoair Reauirements
? 2 copies of plan
? 2 site surveys (exterior additians 8 decks)
? 1 energy calculations for heated additions
CONSTRUCTION COST; ?2 ?Od
STREET ADDRESS:
LOT: f BLOCK: ? SUBD./P.I.D. #:
/ `"'7!h
Name: ??'Lr?GC?dJ ( 4.G?ci Phone #: 4??-o
PROPERTY Last ? First ?
OWNER
StreetAddress: 2/,i Cf__r^? ?? gc,?
City State: Zip:
Company vid?st? QPhone # ?CI ?'3 S`UC?
CONTRACTOR ?,T//49 • .
Street Address: liD ?Yl Ldui?f License #aDti lLl ?? Z O?
City State: Zip:
ARCHITECT/
ENGINEER
Phone #:
Registration #:
Street
City Stare:
Sewer & water licensed plumber (new construction ony):
and lot change is requested once permit is issued.
Zip:
Penalty applies when address chang
I hereby acknowledge that I have read this applicaGon and sfate that the infortnation is correct and agree to comply wRh all applicabl
State of Minnesota Statutes and City of Eagan Ordinances. ?
Signature of Applicant
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received - Yes - No - Not Required
1988 BOILDING PEAMIT APPLICATION - CITY OF EAGAN
. y
SINGLE FAMILY DWELLINGS
15 169 Y
ZNCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS
IS DESIHED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
MULTIPLE DWELLINGS RENTAL ONITS FOR SALE UNITS # OF UNITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECR WITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS ,
COMMERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS
To Be Used For: A7T*1YM6Ar?*E yaluation: 9000- Date:
Site Address
Lot ? Block
Parcel/Sub
Owner
Address
City/Zip Code lA
Phone
Contractor V/7'LLc 7 ICG/'???'Jl?L??
Address O(? P( 9"/L6
City/Zip Code
Phone y?Gl - ?`? /? .S
Areh./Engr.
Address
City/21p Code
WD ;.. 1 MR
On site sewage_ Oceupancy JY{-1
MWCC system _ Zoning YL-1
On site well _ Actual Const V-N
City water Allowable V-N
PRV required 41 of stories
Booster Pump _ Length 2 '
Depth 24'
S.F. Total
Footprint S.F.
APPROVALS FEES
?Engr/Assess Yermit 90,00
Planner Surcharge y,o.?
Couneil Plan Revlew
Bldg. Off. SAC, City
Variance SAC, MWCC
Water Conn
Water Meter
Road Unit
Treatment P1
Parks
Copies ,Jo
TOT9L 99,00
Phone fl
.
CITY OF EAGAN N0 15 2 9 6
3830 Pilot Knob Road, P.O. Box 27-199, Eagan, MN 55121
BUILDING PERMIT PHON E: 454•8100 Receipt # a '
?S I
To be used for GARAGE Est. Value $8,000 Date .iULY 1 ,1988
SiteAddress 2139 CLIFFHILL LN
Lot_LBlock 2 Sec/Sub. C FDAR CT.TFF 1ST
Parcel No.
m Name GREG FALVEY
? Address 2139 CLIFFHILL LN
0 City EAGAN phone 452-5760
o Name VALLEY REMODELING
?a Address 2981 PILOT KNOB RD
? City EAGAN phone 454-3163
W
W
z
?
z
W
Name
Address
City _
I hereby acknowledge that I heve read this applicahon antl state that ihe
rnbrmahon is wrred and agree to complM?ll applicable State of
Minnesota Statutes an -C' f Eaga Or fn
Signature of Permdt 1'?"Y c.>ir
A Bwlding Permit is issued to ? ALLEY REMODELINf_
on the express contlition that al I work shal I be done in accordance with all
apphcable State of Minnesola Sta[utes and City of Eagan Ordinances
e
Bmlding Official
OFFICE USE ONLY
On Site Sewage _ Occupancy M-1
MWCCSystem _ Zoning R-1
On Site Well _ (Actuap Const V-N
Cirywater _ (Allowable) V-N
PRV Reqwred _ # of Stories
Booster Pump _ Lengih 27'
Depth 241
S.F. Totel
Foo[print S.F.
APPROVALS FEES
Engr./ASSess. Permit 90.00
Planner Surcharge 4.0S1_
Council Plan Review
Bldg. ON SAC, City
Variance SAC,MWCC
Water Conn.
Water Mefer
Road Unil
Treatment P1
dMCopies 1.00
TOTAL 95.00
`valleo JnueAftnient L'o.
2981 PILOT KNOB RD.
EAGAN, MINNESOTA 55121
(612) 4543163
PG 0 l7`l()
id
?D ? ?d ?
? -%?
? r
,
?
op .
?.y '? ?00 rT .Z
, .
?) q
, ?V A
?V qb
\
.? C
? F-
P
` ' . T
CITY OF EAGAN No 7308
3795 Pllof Knob Road Eeyan, MN SS122 _
iHONE: +54-8100 ?U 3LI
BUILDING PERMIT Receipt # _I
Te ba wad fer SF DWG Est. Value $44r000 _Dare June 2 19 82
Sit, Addreu 2139 Cliffhill Iane
Lot
pa,ce 1
? # BI«k 2
10 16600 Sec/Sub. Cedar Cliff lat
010 02
? NoR,e Zachman H omes. Inc.
Z Address 7760 Mi thh@ll Road
? Ci Ed en Prairie pho,,, 937-9520
o Name - Oarnet
?
z?
Addreu
Ci Phone
GW
Name
I
f
zZ
Address
I hereby ockrqwledge thot I have reod this application ond sfote that
fhe intormation is [orrect ond ugree to wmply with all opplicoble
State of Minnesota $tatutes and City of Eagan Ordirwnces.
Erect XX Occupanq R-3
Alter ? Zoning R-1
Repoir ? Fire Zone NA
Enlarge ? Type of Const. V
Move ? # Storfes
Demolish ? Length_36
Grade p Depth-26_-Sq. Ft.-
Approvols Fees
Assessment _
Water 8 Sew.
Police _
Fire
Eng.
Ptonnar _
Countfl _
Bidg. Oft. _
APC
SiBnoture of Permittee -
A Building Permit Is issued ro: 2 8CbmII HOLl98 C.
all work shall be done in accnrdance with all applicable Stote of hy wBuildinp Official ?
.. ..,.. -- - '. ___. . _ . . - - .. .
? 01 1 23-
-7i?dK CITY OF EACAN
Perrriit 256.00
$urcharge 22.00
Plan check 128.00
SAC 525.00
Water Conn. 420.00
WaterMeter 6n_00
Road Unit 240 -(lfl
Toral $1651.00
n fhe ex?reu condifion thnt
04 EoOdn Ordinonces.
Inciude 2 sets of plans,
1 site p1an w/eievators &
BUILDING PERMIT P,PPLICATION 1 set o` energy calculaticns.
Zb Be Used For S I? Valua n ly??o Date ?Wa -Z?
Site Address: 2 OFFICE USE O%7,Y
Lot Block Sec./S
&AD S??t X_ Occupancy _?,?
Parcel '=: 1 o Rp(p Oo a(p 02 Alter Zoning Al
Repair Fire Zor.e
Raner: Enlarge _ 'iype of Const.
Move c Stories
Pddress: :?(QQ 1(`1?qzl?lQ Demnlish Front ft.
City/Zip Code: ??? Z?,n q,? k Grade Depth ft.
Phone i!:
Contractor: _
Pddress:
City/Zip Code:
Phone ":
Arch. /F1ng _ :
F,ddress:
City/Zio Code:
Phor.e
.-.-
APPRMP.LS FEES
Assessments
Pesmit d4-
Sli
x
Water/Se.aer Surcnarge _
ae? co
Police Plan Check la g='0
Fire SAC
Enq, Water Corn.
Planr?er Water Meter
council ,
- Road Unit
- ? yo -C9
Sldg. Off. ,
?
APC
RC7L'A. A jlP 5l'O C?
<.:ALVIN H. HEDLU6_J _
,.
' ... Li Suiveyor CIrI1?Enplnesr
? surve#or`s G'ed?f "?cate
9609 Girard Avenue Souen
Bloominqroo,Minnesoro 55-.
Phone : 8 B 9-20 BO
JOB N0.
)j
SURVEY fOR: 2achman Homea
DESGRIBED AS: Lot 1, Blxk 2, CEDAR CLIFF, City of 8agan, Dakota County,
Minneaota, and reeerviaq easewenta of record.
. I
qa2.4 ? 401.7
30 ?- - - - 100.00- - - - -? 904.3
I I
Top aF F'oundd+ion =-1o :
8asemen+ Floor = 9j)3
W I ? Garaye F/oor = 905.b
( > I I Proposed EleVatron; C-
p p I 1DO Existin9 Efcvatlon?
i N ? ?N Denotes Dra?na9c --.
I?
w
! LL I5tc..ke.4 UNEX
LL GAR
? RS ?S,p-IT? L J?L
! -J _1. ?-
`-'
! 30 903.3 Y ? q9.62 ?y 902.4
a --- -
? M M
j 903.0 CLI FFHILL LANE ; 3o2.0
?
i
; C;'RTIFICATE OF SURVEr
I I nereby certify that on 3/10/8Z I aurveyed ihe property described above ono 0,4;,
f r?,e above plot is a cortect representotion ot said survey.
:?TL ' .
Calvin H. Hadlund, Minn. Rey. No 5?:=,4.'
,qrl58
PLUMBING (RESIDENTIAL)
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5674
Please complete for: Single Family Dwellings
Townhomes and Condos when pemuts aze required for each unit
S 1s 5-o
Date C)
Site Address Unit #
Property Owner 1_. Telephone #(?L? I)L) D 7- ?..
Contractor ? U-?G 1x OODQ- w
Address City
State Zip!-!?Lj b 1._La Telep6one#11,5)?nl G 7SlL'll%?
The Applicant is _ Owner Contractor _ Other
Septic System New _ Refurbished Submit 2 sets of plans and MPC license $ 100.00
InGudes County fee. Additional eonsultant fees may apply.
Alterations To Existing Dwelling Unit, Including $ 50.00
_ Adding fxtures to lower levels or room additions, excluding water softener and water heater
_ Abandonment of septic system
_ Water tumaround (+ 5/8" meter if needed -$121.00)
Other:
_ RPZ _ new installation _ repair _ rebuild $ 30.00
_ Lawn irrigation system
?
Water softener _ Water heater $ 15.00
? replacement _ additional
$ .50
State Surcharge
E
`
2
12 2?03
j-
- ? I
I hereby apply for a Residential Plumbing Permit and aclrnowledge tUat the info tibn is complete and accvrate; wat tne worx vnu
be in confonnance with the ordinances and codes of the Ciry of Eagan and with t e'?lumbing Codes; that I uriderstand this is not a
pernvt, but only an application for a pernut, and work is not to start without a per?; that the wocl?will_be-i? accordance with the
approved plan in the case of work which requ'ues a review and approval of plans. ?
?1t11 ?.11 n vi? ? 2?thr?b.Lz
Applicant's Printed Name 9 Appli t s ignature
J,??? 0 ?,
- ___________-_
j Permit#: l/ ( clD
I
I Pertnit Fee:
? Date Received: "
I
I StafF.
L ---------------
2008 RESIDENTIAL PLUMBING PERMIT.APPLICATION
Date: Site Address:
Cindy Hager
Tenant: 2139 Cliffhill Lane
suite #:
Eagan, MN 55122
RESIDENT/OWNER Name: 6514527022 one:
Address / City / Zip:
CONTRACTOR Name: _ NcyoLGm p rn,Y/f
License Ol!/ l J!/l
?
Address: 2--{0 61 LVl fi V?qo
City: State: r)W Zip: 55 D
Phonel-LYMT[r( • 11'033 ContactPerson: JeSS
TYPE OF WORK _ New _ Replacement _ Repair _ Rebuild _ Modify Space _ Work in R.O.W.
Description of work:
PERMITTYPE RESIDENTIAL
A WaterHeater WaterSoftener
Lawn Irrigation Add Plum6ing Fixtures
? RPZ /_ PVB) ? Main _ Lower Level)
Septic System Water Turnaround
New
Abandonment
RESlDENTIAL FEES:
$50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge)
$30.50 Lawn Irrigation (includes $.50 State Surcharge)
$50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround` (includes $.50 State Surcharge)
'Water Turnaround (add $136.00'rf a 5/8" meter is required)
$100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge)
$90.50 Fire Repair (replace bumed out appfiances, duchvork, etc.) (includes $.50 State Surcharye) C.JO
TOTAL FEES $ SO, r-
1 jjrtroy aukiiowieage uiac mis mrortnanon is compiete ana accurate; that fhe xrork will be fn con ance wkh the ordinances and codes of the City of
ftLcq
Eagan; that I understand this is not a permi; but only an appliption for a permit, and wo s not o start wf t a that the work will be in
accordance with thE approved plan in the case of work which requires a revfew and appro oX < )e-?Fr? ?• ?lrnrbiam, x -?
AppliyanYs Printe me Appl anYs Signature
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PERMIT
City of Eagan Permit Type:Building
Permit Number:EA114315
Date Issued:09/13/2013
Permit Category:ePermit
Site Address: 2139 Cliffhill Lane
Lot:1 Block: 2 Addition: Cedar Cliff
PID:10-16600-02-010
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
Carbon monoxide detectors are required by law in ALL single family homes .
Jeff Pelant
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Cynthia J Childs
2139 Cliffhill Lane
Eagan MN 55122
(651) 452-7022
Legacy Restoration Llc
14000 25th Ave N
Suite 110
Plymouth MN 55447
(763) 354-7660
Applicant/Permitee: Signature Issued By: Signature
1
For Office Use
I ‘) ? 2(9
% % : 1 ° Permit#:
‘„„°4".... 0'4.0 EAGAN
,'��� .'��, 6,0'.
Permit Fee:
Date Received:
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff:
buildinciinspectionst citvofeagan.com L
2018 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date:loji ql I p Site Address: ) 31 C r PQ, 4t.) LK?
Tenant: Suite#:
Name: C-I hcb Ch.' /J J - t-i`t. ( ' Phone: epi Z -6i? '-( 2S�
Resident/Owner V
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jAddressty/Zic *+lay, IC 4 l 15 11-'7 L� r.-z L Z3
Name: 14 `;) ,--- ih? ,License#: 6/(40C t I i'n
I Address: 907 7 Ta—e_ X c? ita City: 1.4......‹. kl,
Contractor
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State: ,�'L-�- Zip: �$ v'��Z,... Phone: Z � /
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Contact: ���^ Email: 'r w„p �C c)c� ' y v&. c' 0,--
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Type of Work New )cepIacement Repair Rebuild Modify Space Work in R.O.W.
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Description of work:
RESIDENTIAL
1 Water Heater
i Water Softener
Lawn Irrigation( RPZ/ PVB)
Permit Type 1
Add Plumbing Fixtures( Main/ Lower Level)
Septic System
New I Water Turnaround
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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 Add Plumbing Fixtures, Septic System Abandonment,Water Turnaround*(includes State Surcharge)
*Water Turnaround(add$280.00 if a 3/4"meter is required)
$115.00 Septic System New(includes County fee and State Surcharge) TOTAL FEES$
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.gopherstateonecall.orq
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.citvofeagan.com/subscribe.
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 which requires a review and approv of plans.
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Applicant's Printed Name Ap ' ant's Signature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Rough-In Air Test Gas Test Final
Meter Related Items: Meter Size Radio Read Manometer Staff: