3583 Blue Jay Way Unit 103RESIDENT OWNER
Name: Paul SeV a et Phone: 69 I 45 8 (o 22.
Address /City /Zip: 35S3 Lo&J e j (,O 0�irk., 1.03 et.c, 5
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CONTRACTOR
Name: Dr t�► r O P(u I^^^I> F1�t `j License ()COO `PM
Address: V51 5 20 R` —7t:'. CA)
Cit Laite kit it 2 State: M N Zip: 5, 4
Phone: Vo q Coq cri Contact Person: De-6 6r 14 65 `b
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TYPE OF WORK
New X Replacement Repair Rebuild Modify Space Work in R.O.W.
Description of work:
PERMIT TYPE
RESIDENTIAL
X Water Heater Water Softener
Lawn Irrigation Add Plumbing Fixtures
RPZ PVB) Main Lower Level)
Septic System Water Turnaround
New
Abandonment
RESIDENTIAL FEES:
$50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge)
0
$30.50 Lawn Irrigation
$50.50 Add Plumbing
*Water Turnaround
$100.50 Septic System
$90.50 Fire Repair (replace
(includes $.50 State Surcharge)
Fixtures, Septic System Abandonment, Water Turnaround* (includes $.50 State Surcharge)
(add $165.00 if a 5/8" meter is required)
New ($10.00 per as built) (includes County fee and $.50 State Surcharge)
burned out appliances, ductwork, etc.) (includes $.50 State Surcharge)
TOTAL FEES D 0 5
CityofEaaali
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
Applicants Printed Name
DEC 0 7 2009
Use BLUE or BLACK Ink
Permit
Permit Fee:
Date Received:
Staff:
6 .60
J
2009 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: 1? £J 0 Site Address: S3 11 ve c t W2 0 I4o-E (03 u. 5512.
Tenant: Pa U 1. 5e t' a t d Suite
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.gopherstateonecail.org
1 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.
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA132345
Date Issued:08/10/2015
Permit Category:ePermit
Site Address: 3583 Blue Jay Way 103
Lot:052 Block: 04 Addition: Lexington Place 1st
PID:10-45050-04-052
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 4,000.00
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 -
Paul A Sewald
3583 Blue Jay Way Unit 103
Eagan MN 55123--244
(651) 454-8622
K Designers
2440 Gold River Rd Ste 100
Gold River CA 95670
(952) 894-3600
Applicant/Permitee: Signature Issued By: Signature