4470 Slater RdCity of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 4470 Slater Rd
Lot: 021 Block: 03 Addition: Cinnamon Ridge 3rd
PID:10- 17402 - 021 -03
Use:
Description:
Sub Type:
Work Type:
Description:
Comments:
Fee Summary:
Contractor:
e - Water Heater
Replace
Water Heater
Meter Size Meter Type
Clay John
3825 190th St. E.
Prior Lake, Mn 55372
PL - Permit Fee (WS & /or WH)
Surcharge -Fixed
Total:
Manufacturer
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
Applicant/Permitee: Signature
PERMIT
City of Eaan
Permit Type:
Permit Number:
Date Issued:
Permit Category:
Serial Number Remote Number
Owner:
John M Clay
3825 190th St
Prior Lake MN 55372
$50.00 0801.4087
$0.50 9001.2195
$50.50
Issued By: Signature
Plumbing
EA083642
06/18/2008
ePermit
Line Size
- Applicant -
7' ` TER EIEVICE PERMIT
Knob r .od ,..
MN 55122
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Plumber:
Meter No.: fri
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1 are. to comfit with *It f
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ItY OF IIAGAN SEWER SERVICE PERM!
3 . * Knob Rood PE IT NO - 2
Eagoe, MN 55 122 OAT • r. 1 r ,_, i ", ,
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Owner i ':i? � Ln.—L,3104 . in Cr . `
Address:
Site Address: +4 73 Maker. oy_ L.1... r" n:j. ;nalon f .ict. y e T _ 1I
Plumber: F nn?; a ? t
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. 4 3 ,7 . . 00 pct
pd.
1 agree to comply Stith 'the
�h of jwgon C onnection Charge: �,�� 00
Ordinances. ._ Account Deposit: f
Permit'. Fee �' '11 p. -
Sofcharge: 1 51' fact
By ( , ,,---j--- _ . , - / Misc. Charges:
Date of Ir s�S' Total:
Insp.: / , 7 . 3 3 Dote Paid: