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1776 Meadowlark Rd
Date: City of EaQall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For OffrceUse Permit #: 7'40.249 Permit Fee: • - J49 Date Received: Staff: 2010 RESIDENTIAL BUILDING PERMIT APPLICATION 7&11 (iernrw koAk Site Address: Tenant: Suite #: RESIDENT / OWNER Name: 72///11701,4 G 91= G f %J6l Phone: Address / City / Zip: Applicant is: Owner ')(Contractor TYPE OF WORK Description of work: Construction Cost: L3Lj4. � Multi -Family Building: (Yes / No ) CONTRACTOR Name: 71/_,L. 5T$ C_ t ri S.% license #:. 04. ?,/5.---#7,r- (Oa / 5.---7s' SF Address: Y1 q � �--Oc r S� City j 1r.71, ' State: /7%`4/ Zip: S35 9 Phone: Contact: 111F. Email: 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: Sewer & Water Contractor: Phone: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classifiedias 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 CaII 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 1 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. Applicant's Printed Name Ap • ' ant's Signature Page 1 of 2 DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation Fireplace Single Family Garage >C Multi Deck 01 of _ Plex Lower Level Accessory Building WORK TYPES New / Interior Improvement Addition _ Move Building Alteration _ Fire Repair )C Replace Repair Retaining Wall ` Porch (3 -Season) Porch (4 -Season) Porch (Screen/Gazebo/Pergola) Pool DESCRIPTION Valuation Plan Review (25%_ 100%_) Census Code # of Units # of Buildings Type of Construction Occupancy Code Edition Zoning Stories Square Feet Length Width REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile Roof: Ice & Water _Final Framing Fireplace: _Rough In Air Test Final Insulation Meter Size: Reviewed By: J Cv Siding Reroof Windows Egress Window Storm Damage _ Exterior Alteration (Single Family) _ Exterior Alteration (Multi) Miscellaneous Demolish Building* _ Demolish Interior Demolish Foundation Water Damage *Demolition of entire building - give PCA handout to applicant MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Sheetrock Final / C.O. Required ?C Final / No C.O. Required HVAC Other: Pool: Footings Air/Gas Tests _Final Siding: _Stucco Lath _Stone Lath Brick Windows Retaining Wall: _ Footings Backfill — Final Radon Control Erosion Control , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL 06) Page 2 of 2 City of Eaaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink Permit #: Permit Fee: Rtglyp, Dc,_4 c q �t Date Received:SEP // 0 7 20 0 Staff: 2010 RESIDENTIAL BIP ILDING PERMIT,Q'PLICATION Date: g/St( 1 0 Site Address: '776/7'78- iu Tenant:16-oMal l d..itze.g. . (A) At';` -1//14. KIJ Suite #: RESIDENT / OWNER Name: /714404.4.01.- %?,p livir 8/o G*rSeh. Phone: C9si.) z"3 --ys 2-7 Address 1 City 1 Zip: 6 )13g 61,x1 veil /6-44.44,40y -/prawn IT -2 Applicant is: Owner ) Contractor TYPE OF WORK Description of work: /.&iiia✓i ( is1r 4a• -4- 7i a [�✓1 L t/L- 7 /Z' "dial Dw.wfvrats fie,, & biwt Construction Cost 43000'') Multi -Family Building: (Yes / No /Y; _) CONTRACTOR Name: 4'/j,x.L. jr...ciSia./ ip- /License #: 206 3/ 3-7cr Address: 5/93 7:01,61v.044- And"St (03 City: Atlas- ffli #dis State: /i A/ Zip: r4-36-- ) Phone: (fro 2 rz —7 `1 YY Contact: efata..- at, ..,,A Email: c4,4„1/1.4+... a 4 ch#4.. . L_., COMPLETE In the last 12 months, has Yes No If yes, THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING the City of Eagan issued a permit for a similar plan based on a master plan? date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE Plans and supporting documents Chet u Olt are considered to be public Information. Portions of the information maybe c/assitled as non- public 1f torr provide specific reasons that would perms then CIly to ,- onclude t1 of they at trade se+cre& , - 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 confomnance 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 : it; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans, dre-At- Applicant% Printed Name Page 1 of 2 501 • i I776 7L- f 7%&y &acoince_K- DO NOT WRITE BELOW THIS LINE 9-:§/(;)6 SUB TYPES Foundation ` Fireplace _ Single Family Garage _ Multi Deck ' 01 of _ Piex — Lower Level Accessory Building WORK TYPES New Addition Alteration Replace Retaining Wall Porch (3 -Season) Porch (4 -Season) Porch (Screen/Gazebo/Pergola) Pool Interior Improvement Move Building Fire Repair _ Repair DESCRIPTION Valuation ► (.9'"7i, Plan Review (25%_ 100%4) Census Code # of Units # of Buildings Type of Construction REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile Roof: Ice & Water Final Ni Framing Fireplace: Rough In Air Test T' Insulation Meter Size: Reviewed By: Occupancy Code Edition Zoning Stories Square Feet Length Width Final _ Siding Reroof Windows Egress Window Storm Damage Exterior Alteration (Single Family) _ Exterior Alteration (Multi) Miscellaneous _ Demolish Building* Demolish Interior Demolish Foundation Water Damage *Demolition of entire building - give PCA handout to applicant MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Sheetrock Final / C.O. Required Final / No C.O. Required HVAC Other: Pool: Footings Air/Gas Tests _Final Siding: _Stucco Lath _Stone Lath _Brick Windows Retaining Wall: _ Footings _ Backfill _ Final Radon Control Erosion Control Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL (1-11/ ff( fi ani 6I1 7 Page 2 of 2 City of Eagan Eagan, PERMIT City of Eaan Permit Type: Plumbing Permit Number: EA094682 Date Issued: 06/25/2010 Permit Category: ePermit Site Address: 1776 Meadowlark Rd Lot: 007 Block: 03 Addition: Hillandale 1st PID: 10-32950-007-03 Use: Description: Sub Type: e - Water Heater Work Type: New Description: Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments: Paul Koepcke 7402 Washington Ave Eden Prairie, MN 55344 Fee Summary: PL - Permit Fee (WS &/or WH) $50.00 Surcharge -Fixed $0.50 0801.4087 9001.2195 Total: $50.50 Contractor: Centraire Heating & Air Conditioning 7402 Washington Ave Eden Prairie MN 55344 (952) 941-1044 - Applicant - Owner: Linda A McWilliams 1776 Meadowlark Rd Eagan MN 55122 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. Applicant/Permitee: Signature Issued By: Signature City of Eagan Eagan, PERMIT City of Eaan Permit Type: Mechanical Permit Number: EA094636 Date Issued: 06/24/2010 Permit Category: ePermit Site Address: 1776 Meadowlark Rd Lot: 007 Block: 03 Addition: Hillandale 1st PID: 10-32950-007-03 Use: Description: Sub Type: e - Furnace Work Type: New Description: Furnace Comments: Quesetions regarding electrical permit requirements should be directed to Mark Anderson, State Electrical Inspector, 952-445-2840 Paul Koepcke 7402 Washington Ave Fee Summary: ME - Permit Fee (Replacements) $50.00 Surcharge -Fixed $0.50 0801.4088 9001.2195 Total: $50.50 Contractor: Centraire Heating & Air Conditioning 7402 Washington Ave Eden Prairie MN 55344 (952) 941-1044 - Applicant - Owner: Linda A McWilliams 1776 Meadowlark Rd Eagan MN 55122 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. Applicant/Permitee: Signature Issued By: Signature From:ALLSTAR CONSTRUCTION 19529427464 07/20/2010 11:32 #054 P.002/002 *'Cily of Etta 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax. (651) 675-5694 2010-0 RS/Jl�rv7j03L A? BUILDING PERMIT APPLICATION JUL $ 0 EffiD Use BLUE or BLACK Ink kor Permit #; Permit Fee: /, p 7 f.-7 --e5 � Date Received: 7 °'© -/0 Staff: Date: 7/2-49/20/42 Site Address: /769 -17,2 ."1C e w /AA k R.1. ,ALS/ Tenant Name: rie dow/wrC kit>le, yr Uiee RJ (Tenant is: New / „ Existing) Suite #: Former Tenant: PROPERTY OWNER Name: /10,010w/.¢0,¢ £4 j1194 54 G„ ys, 6.10.,ny Phone: '9""2- 22f3- 4112 7 Address / City / Zip:. -%f' C.'6, L.,. -e514 P.,./t -.y, L wr,z P'- :>,•0. 6-3- 3 y}✓ f'14' Applicant Is: Owner X Contractor — TYPE OF WORK Description of work: h+,',.4,v itep/w..e..,cn 1.., ,Qa ,s/de/ „e/.. I ,t?,,®, ,, Pe4 ,5 Construction Cost: /'`/ .. /l'i. CONTRACTOR Name: ,4//5714 4n51,adi1m -01 4.410.,# License #: 204 j/d" 7S" Address: S/'f$ reacd enu/ Sd. 54014 /0 3 City: "'1../ /a e41,1 State: M4,- Zip:5',�"3s"9 Phone: (9.5-2) 1.5/2 - 7`✓s `' ye Contact: Gv//anyy �e,,,0d�.+ys�os.y Email: 44,#e /p/o�} a//4t'a,t. A 717. 1V2 7Vsy ARCHITECT / ENGINEER Name; Registration #: Address: City: State: Zip: Phone: Contact Person: Email: Licensed plumber installing new sewer/water service: Phone #: � x cNOTF'''fig andsuppor#rn,9 c oc ments` hat yo r su r tare conside d to bepubli v QfrrtatPo�t kPortions of� th q rmation ma � Yke cls�r�,�d as non pubU�,f�rou provrde,�A�rf#ic f-eaons ���tp►'�oulsi,,pant?rt�t�h� �i�r�o� t. ..w... .t. � onclude that, they,` are tra a secrets nt{ ., • i FV Fr;. .. 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.gpoherstateonecalforg 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, x 'Z -1549N ,p. c7,( 61.4 Applicant's Printed Name x Ap • ' ant's Sign Page 1 of 3 y -7 r/Dt s(7E-b DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation Fireplace Single Family _ Garage Multi _ Deck _ 01 of Plex _ Lower Level Accessory Building WORK TYPES New Addition Alteration Replace Retaining Wall Porch (3 -Season) _ Porch (4 -Season) Storm Damage Exterior Alteration (Single Family) Exterior Alteration (Multi) Miscellaneous Porch (Screen/Gazebo/Pergola) — Pool Interior Improvement Move Building Fire Repair Repair DESCRIPTION Valuation / 4/6-090 Occupancy Plan Review Code Edition (25%_ 100% ) Zoning Census Code X39 Stories # of Units /p Square Feet # of Buildings / Length Type of Construction -73 Width REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile zcdroitoK tyrtdT Roof: lifer Finales ' Framing Fireplace: Rough In Air Test Final Insulation Meter Size: Reviewed By: RESIDENTIAL FE Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL / 3"G 3* 6 t 04/84 Siding Reroof Windows Egress Window — Demolish Building* — Demolish Interior Demolish Foundation Water Damage *Demolition of entire building — give PCA handout to applicant Z3G – 3 MCES System Aco2 SAC Units 2- City Water Sheetrock Booster Pump PRV Fire Sprinklers _ Final / C.O. Required Al Final / No C.O. Required -.O' — Cid 146# /4'I/ HVAC Other: Pool: Footings _Air/Gas Tests Final Siding: Stucco Lath _Stone Lath _Brick he Windows Eik / /,vIr Retaining Wall: Footings Backfill Fina Radon Control Erosion Control Building Inspector Page 2 of 3 1 siding final for the entire bldg PARTIAL INSPECTIONS FOR EACH UNIT 1764 (East end) roof (flat roofs over garages only) roof deck (prior to new membrane) deck (on top of membrane roof) windows smoke detectors water damage? 1766 roof (flat roofs over garages only) roof deck (prior to new membrane) deck (on top of membrane roof) windows smoke detectors water damage? 1768 roof (flat roofs over garages only) roof deck (prior to new membrane) deck (on top of membrane roof) windows smoke detectors water damage? 1770 roof (flat roofs over garages only) roof deck (prior to new membrane) deck (on top of membrane roof) windows smoke detectors water damage? 1772 roof (flat roofs over garages only) roof deck (prior to new membrane) deck (on top of membrane roof) windows smoke detectors water damage? 96o 111660u.)\)q-d_ ./k c( 1774 roof (flat roofs over garages only) roof deck (prior to new membrane) deck (on top of membrane roof) windows smoke detectors water damage? 1776 roof (flat roofs over garages only) roof deck (prior to new membrane) deck (on top of membrane roof) windows smoke detectors water damage? 1778 roof (flat roofs over garages only) roof deck (prior to new membrane) deck (on top of membrane roof) windows smoke detectors water damage? 1780 roof (flat roofs over garages only) roof deck (prior to new membrane) deck (on top of membrane roof) windows smoke detectors water damage? 1782 (West end) roof (flat roofs over garages only) roof deck (prior to new membrane) deck (on top of membrane roof) windows smoke detectors water damage? EAGAN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454.5242 PERMIT FOR SEWER SERVICE CONNECTION DATE: may 4, 1972 NUMBER 99) OWNER: Buare - Hillendale Bldg. f1 Address PLUMBER Weierka Excavating I Loc TYPE OF PIPE DESCRIPTION OF BUILDING ::tiuVy CaJt Iron ustrial Commercial Residential Multiple Dwelling No. of units 10 Connection Charge Permit Fee 10.00 14 14/72 •%0 14 :14/72 s/e Street Repairs Total Inspected by: 4 Date S y. Remarks: By Chief Inspector In consideration of the issue and delivery to me of the above permit, I hereby agree to do the proposed work in accordance with the rules and regulations of Eagan Township, Dakota•County, Minnesota BY idoiu •f,c Ti�;tl:;liin:, ract;VuLit�`a, �Li1Y .w ci, 1:4:g41-1 55123 Please notify when ready for inspection and connection and before any portion of the work is covered. From:ALLSTAR CONSTRUCTION 19529427464 1,0/18/2012 .16:37 #614 P.009/010 *' City otEakan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Date: i 7 C1 Use BLUE or BLACK Ink For Office Use '% f / 56 Permit #: /r / / Permit Fee: // 6 Date Received: / / A Staff: 2012 RESIDENTIAL BUILDING PERMIT APPLICATION Site Address:/ G y / ?66 /7 L' / ) z % 7i` / • - r 7c.) og-2- Unit Si: RESIDENT >'/ OWNER Name: /1-24,..4. is/1- �4€ 77 r ria.. �, 7 Phone: 9r 2) 2,-..7-79 f Address / City / Zip: 3fl a. /�a,rf �k-� �a z ,.,�• :� �.1,i / 3/Y Applicant is: _ Owner ,C Contractor Construction Cost: * G d, eta Z J Multi -Family Building: (Yes / No ) Company: A/sf-a: 004afr7..r,7Sv� A-ta„.H a•,it LL Contact: Gail/ra4f/&,rs,' t,O CONTRACTOR Address: �1%S Z ;.•/ i./4;2444dl,rli./4;2444 J J4 e / City: 4,4,,��o _ P/4 1 ,,, State: /4a✓/9Zip: ��s---7 Phone: 95.-2- - 272-- 715y License#: %3e b3157( Lead Certificate #: /lint- Z®% r- 0 If the project is exempt from lead certification, please explai why: (see Page 3 for additional information) 7 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 the are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Cali 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.000herstateonecaliorq 1 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 penult issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit Issuance. X LGL //.i, ,Y2 G i eT a 7r Applicant's Printed Name App ii cant's Sign Page 1 of 3 DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation _ Fireplace Single Family Garage Multi &'L151,ti Deck 01 of _ Plex Lower Level Accessory Building WORK TYPES New Addition Alteration Porch (3 -Season) _ Porch (4 -Season) Porch (Screen/Gazebo/Pergola) _ Storm Damage Exterior Alteration (Single Family) Exterior Alteration (Multi) Pool Miscellaneous 1. 6 (M4ifil-rai tenor Imp nrovement _ Si ng _ Demolish Building* Move Building _ Reroof _ Demolish Interior Fire Repair Windows Demolish Foundation `� , Replace 1 _ Repair /_" Retaining Wall DESCRIPTION Valuation Plan Review (25%_ 1004, ) Census Code # of Units # of Buildings Type of Construction REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile Roof: Ice & Water Framing-�" SOF Fireplace: _Rough In "‹., Insulation 1I Sheathing Sheetrock Reviewed By: Final Occupancy Code Edition Zoning Stories Square Feet Length Width Air Test _Final Egress Window Water Damage *Demolition of entire building — give PCA handout to applicant MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Meter Size: Final / C.O. Required Final / No C.O. Required HVAC _ Gas Service Test Gas Line Air Test Other: Pool: _Footings Air/Gas Tests _Final Siding: _Stucco Lath _Stone Lath _Brick Windows Retaining Wall: _ Footings _ Backfill Final Radon Control Erosion Control .-� , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 From:ALLSTAR CONSTRUCTION 19529427464 09/30/2013 15:19 #670 P.005/016 0(04, l'1ta' 11c08) 1174117 -ib , n15 City of Etall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 ►-ria , 1-17a (16o t Il $`A Use BLUE or BLACK Ink For Office Use Permit#: 1 1 $lo^� Permit Fee: 4 • a C Date Received: °Ai 301 ,3 Staff: J f`�A �n 2-013 Site BUILDING PERMIT APPLICATION 1— 30 a Lo13 Site Address: 1149 C/v'L CI y ?0� r to un , Date: M�U� vV � 11/11 IC Unit #: Name: Meac1c N aVkGRt I � C/o • lilaSSP,n Compa Phone: Address / City / Zip: tr-i3� We_lt POlricvvouLli t- QX11?latrie1 MN 5c3yy Applicant is: Owner Contractor description of work: --To off and ye -roof- Ghd qd ( rig Construction Cost: $211131.y4 Multi -Family Building: (Yes K / No Resident/ Owner Type of Work Contractor Company: f Mt -al( t DnchttiOn Mt f ntiwc,Contact:.. lot ittISfaci Address: Gilt1S 1%10(10 Sile ,* IDS City: aw, "Plain State: MN Zip: 55 r Phone: %l- c L 2 _ 1L v -T License #: 15003119 Lead Certificate #: N n 1 1D9 109- 0 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 hat 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.00aherstateonecall.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 Smote Building ode must be com eted within 180 days of permit issuance, Applicant's nted Name x AppliQ`an>)'s Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA172505 Date Issued:10/04/2021 Permit Category:ePermit Site Address: 1776 Meadowlark Rd Lot:007 Block: 03 Addition: Hillandale 1st PID:10-32950-03-007 Use: Description: Sub Type:Residential Work Type:Replace Description:Standard Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Please call Building Inspections at (651) 675-5675 to schedule a final inspection. 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 - Nalini Gundabathula 1776 Meadowlark Rd Eagan MN 55122 Champion Plumbing 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 Applicant/Permitee: Signature Issued By: Signature