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3590 Blue Jay Way Unit 200RESIDENT / OWNER Name: s IG b 6/G 6` ' t...'' Phone: / z/5 5 S a ,?, Address / City / Zip: 15 If hC T Lad S GC, j� �e- ,wc3 , Y CONTRACTOR Name: License #: - wet Address: r C EA A .C)'DI" 7402 Washington Avenue City: Eden Prairie, MN State: Zip: 55344 •=rS? " 041 =1044 (�� =e-u ve -L Phone: Contact Person: TYPE OF WORK New Replacement _ Repair Rebuild Modify Space Work in R.O.W. Description of work: PERMIT TYPE RES DENTIA! ?e , 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, (includes $.50 State Fixtures, Septic System (add $165.00 if a New ($10.00 per as 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 Surcharge) Abandonment, Water Turnaround* (includes $.50 State Surcharge) 5/8" meter is required) built) (includes County fee and $.50 State Surcharge) ductwork, etc.) (includes $.50 State Surcharge) t+ „ TOTAL FEES $ .L ./ burned out appliances, City of Eapil 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 � LC�L.NIG OCT 3 0 2009 2009 RESIDENTIAL PLUMBING PERMIT' APPLICATION Date: 1V AP•P Site Address: 3J 90 GG .. - TAY Tenant: lT` /&4# C I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with Eagan; that I understand this is not a permit, but only an application for a permit, and wor is not � start accordance with the approved plan in the case of work which requires a review and approy plan 4 satrc_k----- Applicant's Printed Name FOR OFFICE USE Appr(ican s Signature 9g40 - cR , For Office; Usi Permit #: / /5" / D Permit Fee: o ' S-o Date Received: / O Staff: Suite #: Required Inspections:. ` Under Ground Rough -In Air Test Gas Test Final 20 codes of the City of e work wit be in Reviewed By: ` Date: öëö ÿü ÿ þýý ûðûü úýýðï íø äè ä þýö þýüûúùîý ûúùöø ùîý Þý ù ô ïý ô ëýü ã ÿþ ù ÿ ý ä ýåù ë ì ã ôîáõùô ßæêê õú þý ë îèæêäêä ôïóï öòñ ùù ò ó Ý ò þùëú ë ìñäýâúú ãöñ ãöñ áäßä ë üúø ë ëì ë ùù ëëé ô ôùúøëùùüþ éã þý òúé í ê ùù÷ ôþ ý ýúþ ý