1855 Sleepy HollowRESIDENT / OWNER
Name: L k
j`
(.)D . Phone: q.5 D l
( � 3 - 1- A ( ,
Address / City / Zip: ' TO `•
0 D (
e
3
CONTRACTOR
Name:
CC
I ( a �/ r . License #: C 73 p y
Address: _ 7
31 -P' �,
,
City: C��
State: ( Zip: 66 Phone: J 7 3 ) 3)
Contact: ,/ \
E mil -
TYPE OF WORK
New
of
_ Replacement Repai x Rebuild Modify Space Work in R.O.W.
Description
_
work:
PERMIT TYPE
RESIDENTIAL
Water
Heater
Irrigation
RPZ
System
/ PVB)
Water Softener
Level)
1 Lawn
Add Plumbing Fixtures
( Main Lower
Septic
_
_
Water Turnaround
New
Abandonment
RESIDENTIAL FEES:
$50.50 Minimum Water
Heater, Water
(includes $.50
Fixtures, Septic
(add $166.00
New ($10.00
State
if
per
out appliances,
Softener, or Water
Surcharge)
System Abandonment,
Heater and Softener (includes
$.50 State Surcharge)
$.50 State Surcharge)
TOTAL FEES $
$30.50 Lawn Irrigation
$50.50 Add Plumbing
*Water Turnaround
$100.50 Septic System
$90.50 Fire Repair (replace
Water Turnaround* (includes
a 5/8" meter is required)
as built) (includes County fee and $.50 State Surcharge)
ductwork, etc.) (includes $.50 State Surcharge)
burned
CityofEaaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
APR 26 2010
x
Applicant's Signature
Use BLUE or BLACK Ink
Permit #: 3 6
Permit Fee: % 67:)
Date Received: / - 07 " f
Staff:
2010 RESIDENTIAL PLUMBING P RMIT APPLICATION
Date: 'aa� (� Site Address:
Tenant:
J
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.gooherstateonecall.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 of to start without a permit; that the work will be in
accordar with the appro d plat in the case of work which requires a review and approval of s.
x 0 (4
Appl c nt's Printed Name
FOR OFFICE USE
Re
der Cram:
Reviewed By:
Rough -ln Air Te
F.: Eoice Use
City of Ea i ~ Permit
Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff: I
I 1
2008 RESIDENTIAL BUILDING PERMIT APPLI AT O
Date: Site Address:
Tenant: Suite
RESIDENT / OWNER Name: Phone:
Address / City / Zip:
Applicant is: Owner Contractor
TYPE OF WORK Description of work: ~CjC!-112
Construction Cost:c 2 i Multi-Family Building: (Yes, / No
CONTRACTOR Name:_ 6 ! f Z'- /Vif 1;,7 1e,17 v7Cf~ License
Address: _21Z)0 GGY1? l 2Y~O
City: Ajiliz6wl State: ~'d771r7 Zip: -55,1,3
Phone: !C>1.- 3 ,~0 3 fPZ,-0 Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Category 1 Minnesota Rules 7672
Energy Code Residential Ventilation Category'l Worksheet New Energy Code Worksheet
Category Submitted Submitted
(4 submission type) - Energy Envelope Calculations Submitted
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 suppdrting documents that you submit are considered to' h - 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.
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 1
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
,ccordance with the approved plan in the case of work which requires a review and approval of plans.
Applicant's Printed Name C Applic is ignature
Page f 3
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA142266
Date Issued:04/24/2017
Permit Category:ePermit
Site Address: 1855 Sleepy Hollow
Lot:148 Block: 02 Addition: Cliff Lake Townhomes 2nd
PID:10-17791-02-148
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description: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.
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 (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 -
Ledell H Peterson Ii
1855 Sleepy Hollow
Eagan MN 55122--246
(612) 919-3328
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature