2107 Cedar Grove Tr - Unit 105l5 City of Eagan
:nant:
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
ESIDENT OWNER
CONTRACTOR
TYPE OF WORK
PERMIT TYPE
2008 RESIDENTIAL PLUMBING PERMIT APPLICATIO
ate: I1 4 —(l(� Site Address: Sri Ctti a r £rt 6
4 1 0 5
Name:
Address City Zip:
Name:
Address:
City:
Phone:
Description of work:
RESIDENTIA L
Water Heater
Lawn Irrigation
RPZ
Sentic System
New
Abandonment
ESIDENTIAL. FEES:
10.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge)
10.50 Lawn Irrigation (includes $.50 State Surcharge)
10.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround (includes 5.50 State Surcharge)
"Water Turnaround (add $136.00 if a 5/8" meter is required)
.00.50 Septic System New ($10.00 per as built) (includes County fee and 5.50 State Surcharge)
=0.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge)
TOTAL FEES S �i .50
ercby acknowledge that this information is complete and accurate: that the work will be in conformance with the ordinances and codes of the City of
clan: 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
:ordance with the approved plan in the case of work which requires a review and approval of plans.
J 9P r
;piicent s Printed Name
iR OFFICE USE';
.quiredilnspections Under Ground`
.,6_
L#1 Idi Upton
651- 365 -1340
3or9 Uodd Rd. #100
Eagan, MN 55123 1339
Contact Person:
Repair
Rebuild
New 'Replacement
k r A 4
Water Softener
Phone:
License
State: Zip:
Add Plumbing Fixtures
Main Lower Level)
Water Turnaround
x
Applicant's Si ature
For'Offce
Permit
Permit Fee:
Date Received:
Staff:
5140
J
Suite By
(OF7_' 5D1 -8943!
__Modify Space Work in R.O.W.
NOV 2 8 2008
3
14-0