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1764 Karis WayDate: City of kali 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Permit #: Permit Fee: 1 03 V-1. 21 Date Received: Staff: 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Site Address: � rr1" P 1'1C ,,1%LY IG,crii tY Unit#: J Resident/ Owner Type of Work Name: /2 /,dbc..—Gvt Fr-fe 1S* 1" Phone: Address / City I Zip: r'ei-h Applicant is: Owner V- Contractor Description of work: Jl r%I i'L Construction Cost: t —0 d u v Multi -Family Building: (Yes ),:(/ No ) ContractorAddress: Company: 141)r121'1 litikve,1/k P Contact: l A 1e? ‘fr 4 &- (3 ?-1%S 5�Ff �t � City: 6.,,,,,,,,,z,_ State: MA Zip: ') < 337 Phone: G 1)--1(-- 5 r d License #: 2-03 f' Cl Lead Certificate #: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) In the last 12 months, Yes _No If COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING has the City of Eagan issued a permit for a similar plan based on a master plan? yes, date and address of master plan: Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: Phone: Phone: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that the are trade secrets. 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 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. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. x 4frt 01 Applicant's Printed Name x f/k. Applican gnatm Page 1 of 3 RESIDENT / OWNER Eagan, MN 55122 Name: 6515921022 me: Address / City / Zip: _ CONTRACTOR r Name: NORBLOM PLUMBING CO. License #: O P l 5 ^� 1 _ Address: (612) 827 -4033 City: 2905 GARFIELD AVE. SO State: Zip: MINNEAPOLIS, MN 55,408 Phone: Contact erson: Arn TYPE OF WORK New X Replacement Repair Rebuild Modify Space Work in R.O.W. _ _ Description of work: Lep1Ace, Water hear PERMIT TYPE RESIDENTIAL 1 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) $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 $ C!tyofEaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 x j L-� �VOrbt ®mi Applicant's Print Name Jason Nord 1764 K aris' A• ' icant's Signa re Permit #: Permit Fee: 6 O Date Received: Staff: 2009 RESIDENTIAL PLUMBING PERMIT APPLICATION f�j Date: I I J' 0 Site Address: Tenant: Suite #: 1 here a t hat 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. RESIDENT / OWNER Name' / , V\ C Phone:U L D 1 3 °ta. 1(Y 7? r Address / City / Zip: t� La L ®A , =t _r\ J3 [ CONTRACTOR Name`-- r' AN " .1 i 1 NI ! O , - f - #: - - \ L Address: L b %L TA ‘,1, City: . angl Stater\ Zip: I l b `p Phone: 1 \ 'T S.O Lo1 Contact Person: C 1 TYPE OF WORK New .Replacement Repair Rebuild Modify Space ! Work in R.O.W. Description of work: PERMIT TYPE RESIDENTIAL 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) $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 $136.00 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) U TOTAL FEES $ City of Eaaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 2010 Permit #: s o Permit Fee: Date Received: Staff: 2008 RESIDENTIAL PLUMBING ^ PERMIT APPLICATION Date: 1 10 Site Address: ��� rc=� Tenant: Applicant's Printed Name x Applicant's Signature J Suite #: I hereby acknowledge that this information is complete and accurate; that the work will b in conformance with the ordinances and codes of t C i t y 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 accor ance with the ap. oved plan in the case of work which requires a review and approval plan n 9 Reviewed By: Date: Under Ground Rough -In Air. Test final FOR OFFICE USE Required Inspections: Gas Test �!^► s 1 33 7'E: ; 1; i �;, �> Ti'T't No. of l r }�. i= �1�3Si� Z )wner: .rr Jr { `I orAr. Son }l es an _ x 31 1 . F Vie. P a',,. 'imiair t .: ; Y� »� t 5 ..► P 01111 ,;/ Misc. f ,OO Dd eteZ Ow* ell Total: BY Date Paid: Doti of Insp.: / Insp.' .0 - �\ P� • ' $ •DATE: t > r zoning:. - w No. of units: 17( r s "a J 1.4 BI nid .1 if III a • / / �2 4 1:, :. -'F.Y �Romou tis it; � � , Surcharge: '' ; �' " - Date e. of Inap.: Total: - Crisp.: _`c''i / .F .pie Paid: , Use BLUE or BLACK Ink r For Office Use Permit City of EaEd~ I I Permit Fee: 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: I I I 2013 RESIDENTIA/L~ BUILDING PERMIT APPLICATION Date: D 7 /3 Site Address: lwr/ Y - )14w//t Unit Name: Phone: Resident/ Owner Address / City / Zip: Applicant is: Owner X Contractor Description of work: T/ l~ Type of Work Construction Cost: Multi-Family Building: (Yes / No ) Company: /0 Contact: e YrG'1,,Y,ek? 4 Contractor Address: ,4 City: State: / Zip: ~~33 Phone: L I~'~~6 < L License 0~ -7 Lead Certificate If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW 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: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets 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.clopherstateonecall.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 which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. X ke~ x Applicant's Printed Na a icant's S ature Page 1 of 3 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA148457 Date Issued:03/29/2018 Permit Category:ePermit Site Address: 1764 Karis Way Lot:4 Block: 01 Addition: Ridgecliffe 3rd PID:10-63982-01-040 Use: Description: Sub Type:Residential Work Type:Alteration Description:Fixtures 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. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Fee Summary:PL - Permit Fee (miscellaneous)$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 - Jason K Nord 1764 Karis Way Eagan MN 55122 Mechanical Plus Inc 406 Pierce Street Shakopee MN 55379 (952) 594-5326 Applicant/Permitee: Signature Issued By: Signature