The URL can be used to link to this page

3420 Golfview Dr Unit 313RESIDENT f OWNER 1 Name: AV:.- S■•'%- Phone: (OSI --- Y©5'1 Address / City / Zip: 3 y _ a ® 6 c' v it -(._ 100 1=4 s© -- 44 M "'S'S 1 a 3 CONTRACTOR Name: C L v\ 6 crv'- License #: (j 3 - l Address: ) il S — 6 , l " JT 'VIE City: I c(/ / / / 6 State: .!t Zip: S Phone: 3 - aC (AI e Contact Ch v f3Gr•— Email: r e 0q40 a ,;I . t' 0,-,_ TYPE OF WORK New X Replacement Repair Rebuild Modify Space _ Work in R.O.W. _ _ _ Description of work: L ^ �, +� ` .i+ i� LO, L iA eb PERMIT TYPE RESIDENTIAL Water Softener Water Heater Add Plumbing Fixtures ( Main / 1C •i~c►wer Level) Lawn Irrigation ( RPZ / PVB) _ Water Tumaround Septic System New Abandonment RESIDENTIAL FEES: $55.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) $35.00 Lawn Irrigation $55.00 Add Plumbing *Water Tumaround $105.00 Septic System $95.00 Fire Repair (replace (includes $5.00 State Surcharge) Fixtures, Septic System Abandonment, Water Turnaround* (indudes $5.00 State Surcharge) (add $166.00 if a 5/8" meter is required) New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) bumed out appliances, ductwork, etc.) (induces $5.00 State Surcharge) TOTAL FEES $ 4 0 1 ' City ofban 2010 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: 7 — 80 Site Address: - 7 l2ott tJ e t4 tat" Tenant: A�/ �i�ko✓�- 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675-5694 . 2 I REC1 Use BLUE or BLACK Ink Permit*: Permit Fee: •` Q 0 Ct✓ Date Received: Staff: Suite #: 31 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.aooherstateonecall.orq I hereby acknowledge that this information is complete and accurate; that the work wl be in confonimmice with the ambiances and codes of the City of Eagan; that 1 understand this not a permit. but only an orration for a permk and work is not to start without a permit that the wad( wg be v accordar with the app << ° . in the case c# work wtuch requires a review and approvEd of mss. x CI Applicant's Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA130082 Date Issued:04/02/2015 Permit Category:ePermit Site Address: 3420 Golfview Dr 313 Lot:061 Block: 03 Addition: Tomark PID:10-76900-03-061 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes . Valuation: 4,000.00 Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 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 - Avis E Simon Tste 3420 Golfview Dr 313 Eagan MN 55123 (651) 405-1717 Wellington Home Improvement 3938 Meadowbrook Rd St. Louis Park MN 55426 (952) 933-6300 Applicant/Permitee: Signature Issued By: Signature