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3888 Palisade Way 2011-06-1311:06 651975 5694 P 215 use BLUE Or BLACK Ink For Office Use My"'of E*n I Pem„rlttl: Pamdt Fee: b C .i 3830 Pilot Knob Road l i Eagan MN 55122 4 Data Received: Phone: (631:)675 675 Stsif: Fax: (651)$754494 t__- 2011 RESIDENTIAL PLUMBING PERMIT APPLICATION Datm , l ( Site Address: Tl i W L31141 Tenart s~r~ts 0: RESID ENT I OWNER Name: 4A ~4S~S Phone: ~Q ~ ~L~sS~lcl Address I City I Zip: m*,e as ..ca CONTRACTOR Name' f y License Address; J I~.: OYl A L V3 City; State: Yip:.. Phone, Ct rrtact ~0.s, rl Email gjjj TYPE OF WORK New _ Replacement -Repair i Rebuild - Modify Space Work in R.O.W. 'I r f" A A Al AMA Dasc on of wart: RESIDENTIAL PERMIT TYPE Water Softener Water Heater Lawn Irlgaton RPZ / PVf3) Add Plumbing Fixtures L Main 1- Lower Level) 4- 4- _ Septic system _ waterTurnaround New -Abandorimern RESH)ENTIAL FEES: $55.00 Minimum Water Heater, Water Softener, or Waiter Heater r So'ftener (includes $5.00 State Surcharge) $35.00 Lawn Irrigation (includes $5.00 State Surcharge) $55.00 Add Plumbing Fixtures, Sepdc System 6Mndonm Water Turnaround' (includes $5.00 State Surcharge) Vater Turnaround (add $166.00 if a 518 meter is requited) $105.00 Septic System New ($10.00 per as built) (includes County fee and $5,00 State surcharge) $95.00 Fire Repair (replaos burned out appliances, ductwork, etc.) (includes $6.00 State Surcharge) TOTAL. FEES $ CALL. BEFORE, YOU DIG. Call Gopher stab one Call at ($61) 464 *02 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gooherstateonecall.oro I hereby acknowledge that this Information is complete and aoaurate; thot the wart will to in cordarmfarwe with the wdinancee and codes of the City of Eagan; that I understand this is not a permit, but only an applicatiM for a permit, and work is not to start without a pemltt; that the work will be in accords ce with the approved plan In the Oast: of work which requires a review and approval of plans. x 1 " x ~ Appiieaniess Pr1r;w Naaw Appiign ignaturo FOR OFFICE USE Revknwd By: Data: Required Inspections: Utxier Ground .r,,,,Rough4n _J4ir Teat Gas Test „-Final C-1V CITY OF EAGAN Remarks addic"' Cedar Grove #8 Lot 12 Bik 6 Parul 10 16707 120 06 Owner i? 9? G'.d, /, r Street 3888 Palisade UT3y State EagSri+?I 55?22 Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. STREET RESTOR. GRADING SAN SEW TRUNK 1 ? ? 125.00 .QQ 2 Paid #*WER LATERAL yLy 1 1539.10 307.82 WATERMAIN # WATER LATERAL 1 WATER AREA ? STORM SEW TRK # STORM SEW LAT 1 CURB & GUTTER SfDEWALK STREET LIGHT - WATEFi CONN. 300.00 9807 9-17-73 BUILDING PER. sac 2 0.00 -?7-73 PARK THE SPRING CUMPANY DETACH ANO RETAIN THIS STATEMENT TME TTTPCNEO CMECK IS IN PAYMENT OF fTEM6 OESCRIBEC 6 IOW. CLOSING D1981IR6EMENT lF Nor coewecr wLenee norivv us PwomPrI-v. rvo ReceiPr oesiwso r ? ' DELUXE - F13RM V4VO-3 V-7 505912 S LEMCK&/ROSfi 3888 Palisade Way Special Assessment Search $5.00 a 9' ?'V 41 _ . VILLAGE OF EAGAN 3795 Pilot Knob Road Eagan, Minnesota 55122 PERNLiT NO:: 379 The Village of Eagan hereby grants to Cedar Grove Constrnotion Oo. of 7343 Concord 81vd. East, South St. Paul a HMuAIDING Permit for: (Owner) samg at 3888 Palisade way 12-6-e , pursuant to application dated B/14/73 Fee Paid; $.20.00 dated this 17th day.of August ? 19 73 .50 s c Buildiag Inspector ? Niechanical Permits: Bid Total; . VILLAGE OH EAGAN 3795 Pilot Knob Road Eagan, Minnesota 55122 PERMIT NO.: 399 The Village of Eagan hereby grants to CeBar GroneOonstraation Co of 7343 Ooncord Blvfl. paet, South SC. Paul a HEATrNG Permit £or: (Owner) Sam at 3988 Palisdde way 12-6-8 , pursuant to application dated 8/14/73 Fee Paid: $20.O??dated this 17th day.o£ Auguat ? i9 73 Buildir.g Inspector ilechanical Permits: Bid To'tal: / EAGAN TOWNSHIP BUILDING PERMIT oWne: CP-e ,l?.-o?.-.e, ?'.d-•--=.z'?' ._.. ..-""..------------------- --............-'--_ -"-'............ Addsess (Presenf) ......................... Suilder .............. Address ............ DESCRIPTION N° 3121 Eagan Townnhip Town Hall Dale _._.tQ- °Z 9- 73 ._--- --......---?----? SSaries To Be Used For Fron! Depih Heigh! Esl. Cosf A?.? Pesmit Fee ?•? Remazks ? ?93Z ? .?. LOCATION 3•?s a 5lreel. Road or ofher Deseripfion oi Locafion I Lo! Biock Adduion os Trac! 3 e,4-,r / ,_ If ?' This permii does not au2horize the use of slreefs, roads, allaps ox sidewalks nor does it give the owner o= his agea! !6e righ! !o creale anp siluafion which is a auisanee os whieh prasenis a hezard !o the health, safelp, convenience and genesal welfare !o anpone in the communily. THIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WOA% IS IN PROGRE$S. Thfs is !o ceriify, t6ai.......... `.?.°.:?c.-??.^..:?....... .._-_-..haspermission !o erec! a..:_?K... ?:?.......--.-._-...._upoa the a6ove deseribed premise subjeef !o the pxovisions of the Suildixg Ordinaaee for Eagan Township adopled April 11, 1855. ........... ? r ?-?Y-' ..... ""'_".......... V........_._ ? 5-++-..-•a*.-?J Per ...................................... k" _.".:.......!.:X`t-.z?,-? .'__. ................. .. Suilding Iaspeelor ? Chairman of wn Soard. EAGAN TOWNSHIP BUILDING PERMIT Ownee /'2s"?". ?_"?'G- ..---.....---'--.._:....J..?.._ ................... ..._'---...-'----.....----............... Address (precent) ------- ...-'--:`°------'•-- --'-'°----°--- ................ '------ Buildex Aaa:esa ? . N° 2932 Eagan Towas6ip Towa Hall Dale .%.i:.::.'-?- 7'z 5loziea To Be Used For Fson! Depth Heigh! Esl. Cos! Permi! Fee Remarks ? ou/.cv Streei, Roaa or oiher neserxption oi i.oeatlon I i.02 nioclc naaulon or Tracx ? C, I/<j 5 3 6 T6is parmiY does aot auihorise the use of 621eBS6, i08d8, 8IIBy6 or sidewalks nor does it give !6e owner or hfs agan2 the sigh!!o creale any situalion which is a auisanee or whieh presenls a haaard !o the heal2h, safely, conveaienee and genesal welEere !o anyone in the communitp. THIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WOAK IS IN PROGAESS . > This is !o certifY, ihel---.•?::?_._+r.__....v:y::S--_--.........has parmissioa !o erecY a......?__.. -,-..... -- R?. .... upon `...._ the above described premise subjee! !0 the provisions of the Building Ordinanee fos Eagan Township adopted Apsil 11. 1855. ...... .n"":2"'_"':./.?:.`..: Per ............---'- ?.G??-??-""""-'............""... C• . ` - ? ....."""'?'uilding Impector VILLAOE OF EAOAN SEWER SERVICE PERMIT 3795 PilotKnobRood PERMITNO.: 1402 Eagan. A1N SSlll DATE: 12 29/72 (8/27/73) Zoning: R-1 _ No. of Units: 1 owner: Cedar Grove Construction Co. Address: Site Address: 12-6-8 3 888 PalisadE Wa Plumber: Ste711 I S 1 ogrw ro canOlY vriM tM Village of Eogen Connection Charge:260.00 pd 8/17/: Ordinone„. Account Deposi[: Pernut Fee: 10.00 pd 12/29/72 Surchazge: .50 pd 12/29/72 ? BY: Misc. Chazges: Date of Insp.: Total: Insp.: Date Paid: Bollv 2007 RESIDENTIAL BUILDING rEwHiT nrpLIcATIox cisy arEBgeo 3830 Pilot Knob Road, Eagau MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Canstrictlon ReairanenLs 3 registereC sde aiveys showinp sq. ft. d lak sq. lt ol hwse; antl NJ roWeE areas (20°6 mazimum bl owerage albxed) 7 Stlls Reporl If piaposeA Euidnp Is b 6e placed an dislurhed soil 2 copies of plan tmvirq Eeam 8 win0ow sizes; pouretl fouM eesgn, etc. 1 sel of Eireryy Calwlatlms 3 copies MTrea Pre5Brv06Dn Ren il lal pletl0d aflBr 7l1/83 Rirn Jdst Detail Op6of65elxtlon sheet (EuiMmps wtlh 3 or kss unils) h5nnepBwD methBmral venWation fatm 2 wPiss W plan ahoring IaoBngs, 6eams, jocb 1 set W Ereryy Calculecros kr hested etltlitions 1 site survr/ far edtldlwm 8 decks AdMn-indc&e Ilon-sie aepGC syslem +'I o. C) 0 MIJOA. * , : ',..? H TNF?'IIPWk?d ;: µu?:w:? ThBI1N?'? ,r-? +r>71 Plans aro ennaidarad nuhlic infnrmafinn iiniQac veu cratR thav are trade secret and the reason. Date 10 !2?/20071 CoostracUon cnst 6400 Skenddress -38,& Palisade Way UnidSre N ? re-rOOf c ; Description of Work Cr Muld-Fnmlly 81dg _ Y_ N Fircplace(s) _ 0 _ 1 _ 2 ? e5 Z?I?) PropertyOwner Dave and Laura Ross Teleyhone#( ) Cedar Valley Exteriors Contractor Address 170093rdlanene Ctty blaine State mn Zip55449 TelephoueM( 7637r55221 COMPLETE THIS AREA ONLY IF CONSTRUCTIN6 A NEW BUILDINQ - Minnesote Rules 670 Cateeorv 1 _ Minnes 7672 Energy Cade Category . Realdentlal Ventilelion CateBOry 1 WorMSheet • h7ew Energy Code Workshest (Jaubmlasiontype) $u6mltted Submryted • Energy Envelnpe Calalallons Submilletl In ihe last 12 months, has the City of Eagan issued a permit for a similar plan based on a master planZ _ Y _ N If yes, date and address of master plan: Licensed Plumber Mechanical Coniractor Sewer/Wafer Coniractor a Residential Telephone 7i ( Telephone #f Telephone H( and acknowledge that is complete and accurat e; that the work will be in conformance with the ordinances and codes of the City of Eagan and ttie State of MN Statutes; I understand this is not a permit, but only an application for a permit and work is not to stsrt without a pernti[; that the work will be in accordance with the apgsoVed plan in the ca ?af ork which requires a review and approval ofplans. 1/_1 ^ Emily Bernard Applicani's Printed Name EAG-AN TOWNSHIP 3795 Pilot Knob Rosd St. Paul, Minaesota 55111 Telephoae 454-5242 PERtRIT FOR WATER SERVICE CONNECTION Date: 8/27/73 (12/29/72) Number: 1269 Billing Name;Cedar Grove Construction Site Addreas: 12-6-8 3888 Palisade Way Owner: s aTre Plumber• Stein's Connection Billittg Address Meter Size 7/73 Meter No. PexmiC Fee10.00 pd 12/29/72 .??a?rp "r'rTz?1772- Meter Reading _ Meter Dep. MeYer Sealed: Yes_ lAdd?l Chg. NO ' Total Chg. Building is a: Residence xx N[ultiple Ko, Commercial Industrial Other Inspected by Date Remarka: .00 R'E-!";SrDCT',ON1 Frt' Fr:? u:, ; APEriLY Ei$JI ?LLi? I?1ZIC11J. Hy: Chief Inspector In consideration of the isaue and delivery to me of the above permit, I hereby agree to do the proposed work in accordance with the rules and regulations of Eagan Township, Dakota County, Minaesota. By: stein's Please notify the above office when ready for inspection aad connection. MASTER CARD ?91^e Permit No. ' Issued issued To Contractor Owner BUILDWG PLUMBING CESSPOOL - SEPTIC TANK WELL ELECTRICAL HEATING 3?9 GAS INSTALLING SANITARY SEWER OTHER I OTHER Items Approved (Initial) Date Remarks Distance from Well FGOTWG FOUNDATION , _,. y ?J SEPTIC CESSPOOL FRAMING lm ?,7 '/O ' TILE FIELD FT. FINAL ELECTRICAL NEATING GAS INSTALLATION DEPTH OF WELL SEPTIC TANK CESSPOOL DRAINFIEID PIUMBING o„ WEtL SANITARY SEWER Iz-7- --:; Violations Noted on Back COMMENTS: LOCATION / i4 w/. - :?iT Dr /" ' OWNER STRUCTURE AND ?/? /? +) i LAND USED A$ ?/?/ L? COMPLIANCE INSPECTION R,EPORTS TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS PERMIT NO. DATE OF I CONDIiIONS OF CONSTfiUCTION AT THIS INSPECTION ? NO EVIDENCE OF NON-COMPLIANCE 085ERVED. NON•COMPLIANCE. BUILDER DOES NOT INTEND TO COMPLY. ? ACCEPTABLE SU&STITUTIONS OR DEYIAitONS. ? NON-COMPLIANCE. Bl11LDER WILL COMPLY WITHOUT DELAY. ITEMIZFD AND DESCRIBED AS FOLLOWS: ? COMPLETION OF CERTAIN IMPROVEMENTS WILL BE DELAYED BY CONDfTIONS BEYOND CON7ROL. F-I REINSPECTION REQUIRED OF REINSPEG'fION REVEALED CERTI FICATION -I certify that I have carefully inspected the abwe in which 1 have no interes[ present or prospective, and that I have reported herein all significant conditions oLserved to be at variance with ortlinances of the Town of Eagan, approved plans and specifications, and any specific require- mena for off-site improvemenu relating to the property inspected. ? ALt (MPROVEMENiS ACCEP7ABtY COMPLETED eui - - Chhrge $5.00 - Paid CITY OF EAGAN 3795 Pilot Knob Road Eagan, MN 55122 DATE: September S, 1977 The Snrinp, Compsny 42;5 Sheridan Ave. S. SPECIAT, ASSESSMENT SEARCH ,fels. hLN. 55410 R'W: Lot 12 131ock 6, Cedar Grove #8 10 16707 120 06 3863 Palisade 14a Enclosed herein is the search which you requested made on the at?ove described property: Kind of Improvement Runs Beginning Original:Amt:.':.Balance:Due. NONE I further certify that according to the records of said office, the-following improvements are contemplated or pending after having been approved, and are now in the process of planning or completion. Kind of Improvement Approx. date of completion Approximate Cost NONI: WAIVER: Neither the City of Eagan nor its employees guarantees the acc;uracy of the above information which was requested by the person or persons indicated. Nor does the City or its employeea assume ax?y liability for the correctness thereof. In consideration for the supplying of the indicated information in the above form, and for all other consideration of any nature whatsoever, ax?y claim against the City or its employees rising there from is hereby expressly waived. Levied assessments to be paid to the County Auditor at Hastings, Minnesota 55033. Very truly yours, Anne Goers - Assessnent Clerk/raz SPECIAL ASSESSMENT DEPARTMENT ?? ?3p .5D 7,qq?) 2006 RESIDENTIAL MECHANICAL rExMiT arrLicaTrorr City Of Eagan _ 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete Cor. single family dwellings & townhomes/condos when permits are required for each unit Date ? / ? / o _ _ Site Address GL ?? Unit # Yroperty Owner C (?(•? ? { (? se, Telephone #f Contractor STANDARDHEATINGSAIRCONDITIONING 410 L RRE'-3`fi EET-- ' Street Address MINNEAPOLIS, MN 55408 City State Zip _ Telephone # ( ) Bond #: Expires: _ The Applicant is _ Owner ? Contractor _ Other ni oG Add-on or alteration to existing dwelling unit r -$ -' 30.00 ? furnace _Additional NReplacement , _ New air exchanger ? air conditioner NO Y heat pump other State Surcharge $ .50 Total I hereby apply for a Residential Mechanicai Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Mechanin11 t unde rstand this is not a permi but only an application for a permit, and work is not to start wit t a permit; Chat be in accordance with the appr d plan in the case of?y hich requires a review and approv f p1 s. S?-Z-6? ,,.,A /1__ _ ApplicanYs Printed Name ApplicanY PLIIMBING (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 pemrits are required for each unit ,.t'/S S-0 i Date 03 I ZILGE, ERIC - ? 3888 PALISADE WAY Stte Address I EAGAN, MN 55122 Unit # (651) 452-2156 Property Owner 1? - - - - --? Telephone # ( ) Contrxctor NORBLOM PLlM+I8lNG CO, (612) 827-4033 --- - - Address City • State ip Telephone # ( ) The Applicant is _ Owner $'?- Contractor _ Other Septic System New _ Refurbished Submif 2 sels of plans and MPC Iicense $ 100.00 Includes County fee. Additional consultant fees may apply. Alterations To Existing Dwelling Unit, Including $ 50 00 _ Adding fiMUres 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) aner: _ RPZ _ new installation _ repair _ rebuild $ 30.00 _ Lawn irrigation sys[em _ Water softener X Water heater $ 15 00 X replacement _ additional {5 11 ? . State SurcharSe $ .50 Total $ ( $. SO 8Y --` I hereby apply for a Residential Plumbing Pernut and acknowledge that the information is complete and accurate; that the work witl be in conformance with the ordinances and codes of the City of Eagan and with the Plumbing Codes; that I understand this is not a pemut, but only an application for a permit, and work is not to start without a pernvt; that the work will be in accordance with the approved plan in the case of work wluch requires a review and approva] of plans. Je_-?? No(-6ayy? Applicant's Printed Name A t's Signature PERMIT City of Eagan Permit Type: Building Eagan. Permit Number: EA093791 Date Issued: 05/04/2010 OR Permit Category: ePermit 41~ it~ of E3 E Site Address: 3888 Palisade Way Lot: 12 Block: 6 Addition: Cedar Grove 8th PID:10-16707-120-06 Use: Description: Sub Type: e-Siding Construction Type: Work Type: Sidin, Description: House & Garage Census Code: 434- Occupancy : Zonin,: Square Feet: 0 Comments: When installing ventilated soffit material. remove existina material (i.e. debris that could block vents) and take steps to ensure maximum ventilation to attic. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes. Fee Summary: BL - Base Fee S3K $88.50 0801.4085 Valuation: 3.000.00 Surcharge - Based on Valuation S3K $1.50 9001.2195 Total: $90.00 Contractor: - Applicant - Owner: Capstone Bros Contracting Inc Laura S Ross 216 North River Ridge Cirle 3888 Palisade Wad Burnsville NIN 55337 Eagan NIN 55122 (92)882-8888 I hereby aeknowledae 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 Cite of Eagan Ordinances. ApplicantiPermitee: Signature Issued Bv: Signature PERMIT City of Eagan Permit Type: Building Eagan. Permit Number: EA099343 Date Issued: 05/31/2011 OR Permit Category: ePermit 41 it~ of E3 E Site Address: 3888 Palisade Way Lot: 12 Block: 6 Addition: Cedar Grove 8th PID: 10-16707-06-120 Use: Description: Sub Type: e-Windows iDoors Construction Type: Work Type: Windows Doors-New ; Replacement Description: House Census Code: 434- Occupancy : Zonin,: Square Feet: 0 Comments: Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes. Fee Summary: BL - Base Fee S3K $88.50 0801.4085 Valuation: 3.000.00 Surcharge - Based on Valuation S3K $1.50 9001.2195 Total: $90.00 Contractor: - Applicant - Owner: Apex Energy Solutions Laura S Ross 109 Southcross Drive West 3888 Palisade Wad Burnsville NIN 55306 Eagan MN 55122 (61)688-2739 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and Cite of Eagan Ordinances. ApplicantiPermitee: Signature Issued Bv: Signature 9000 Use. BLUE or BLACK Ink For'Offiee Use t City of Eakan . Permit / I n I 3830 Pilot Knob Road Permit Fee: • t I Eagan MN 55122 Date Received: I Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: I 1 2010 RESIDENTIAL BUILDING PERMIT APPL' Date: l" ~+fi`I ~.ve~ NQ: Site Address: I16~ Tenant: Suite RESIDENT! OWNER Name: `(U,( V- &tt),(,~ / Phone:. c.(/U - S07 ~ 3Ci6 Address / City / Zip: Applicant is: Owner --Y Contractor TYPE OF WORK Description of work: LAG i M 22 Construction Cost: LY2 Multi-Family Building: (Yes / No CONTRACTOR Name: License r1 d~ `7c~ Address: iJ City: State: E Zip: ` 1 C Phone: & - 7,9 c/ t~ V~ Contact: Email: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NVV BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? Yes No If yes, date and address of master plan: Licensed Plumber: Phone: 1 Mechanical Contractor. Phone: Sewer & Water Contractor: Phone: ©TE: Plans and sirppo trng alocrtrrrr s tiat you rrbmi r~ con rdex~d to a bl A,- arin~t axe ► Qris of fie infornratron. may:be;classifred es non-pubfick f yotr prnl~~a ~sP~~c >reasP~s~a~`at~wolr~td. e~m3t i~~C~ =#o : . _.;~anplude that the .r$~a~Fese~rets~ " P CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility dama e. Call 48 hours before ou ' 9 y intend to dig to receive locates of underground utilities. www!.gopherstateonecall ora 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 approval of plans. Xrs ~m Applicant's Panted Name X Applicant's ignature Page 1 of 2 40/11P City of Eagan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5894 2013 RESIDENTIAL BUILDING PE Date: d hs1/3 Site Address: 3.8 g a -PA' 1 /:511-1)F Use BLUE or BLACK Ink For Office Use Permit#: 4 P 50O tR-115113 �5 Date Received: R L1 rJ! 13 Permit Fee: Staff: Lc) APPLICATION L c) Unit #: J {i;�.:. `, :.-k. ,,; C ..'.. • 'ii'';, Name: :OA- 4 CS � / /`� n geO Oto l Phone: to �� Address / City / Zip: 3 g ' PA ( l.S,4i t (- ')A - Applicant is: Owner ✓Contractor f /74. Description of work; /( h,„—/ - k GaCE G/ (/c r„c O( (,v(/1 agli teitafs Construction Cost: w 6� ivpritl-Family Building: (Yes / No ) r +(:; ' ` •;'::;N'k' �' i,G`t . .,.3a ift ' Company: k.,J/ft/ airy �ff Afain gContact: JaE A LScN /. Address: p .3 A.,,, cSE City: 7144,t.) QJ1eI G%Oft_/ State: r)1/11 Zip: H Phone: 76:3 —$ 90 oQ S 7 7 License #: 6c. %,. 90 0 Lead Certiticati #: 4/47" ^ 7 /00 `s( +" (/ If the project Is exempt from lead certification, please explain why: (see P age 3 for additional information) l 6N� r fr-F E l 1 7K COMPLETE THIS AREA ONLY IF CONSTRUCT G A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan il ased on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: I„ ns,, , a� ° /rQ iCi'� tkrtin� Fumenfs that you- Y,. �! f�+' d dp submit are consid red to be public infoririation.�"-:P` tIQtl) classified as. non- ublic if :-, ;::�'you provide spec" lc neasons�thafwould!.�e►rtriC%tli�.., , con e that'.;: clad' ' they' -are trod a refs. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protecti before you Intend to dig to receive locates of underground utilities. A... •o•herstateonecall_o I hereby acknowledge that this information is complete end accurate; that the work will be In Eagan; that I understand this is not a permit, but only an application for a permit and wo accordance with the approved plan in the case of work which requires a review and approval o Exterior work authorized by a building permit Issued In accordance with the Minnesota days of permit issuance_ xJo s �h W . A/E .O/11 Applicant's P Inted Name Z0/T0 39Vc1 311eiH3l against underground utility damage. Call 48 hours nformance with the ordinances and codes of the City of s not to start without a permit; that the work will be In ans. ate Building Code must be completed within 180 App S '/nature E6Z88t'ET59 Page 1 of 3 LE :CZ 8002/LT/T0 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA158921 Date Issued:11/08/2019 Permit Category:ePermit Site Address: 3888 Palisade Way Lot:12 Block: 6 Addition: Cedar Grove 8th PID:10-16707-06-120 Use: Description: Sub Type:Residential Work Type:Replace Description:Standard Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener). 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 - Trevor H Fincher 3888 Palisade Way Eagan MN 55122 Champion Plumbing 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 Applicant/Permitee: Signature Issued By: Signature