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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