4313 Clemson Cir B
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CITY OF EAGAN WATER SERVICE PERMIT
3830 Pilot Knob Road
P.O. tin 1799 PERMIT NO
Eagan, , Mt155121 DATE:
Zoning: No. of Units:
Owner: _
Address:
Site Addess:
Plumber:
Meter No.: Connection Charge:
Size: Account Deposit:
Reader No.: Permit Fee:
I agree to comply with the City of Eagan Surcharge:
Ordinances. Misc. Charges:
Total:
By Date Paid:
Date of Insp.: c ,..2/2 Insp.:
CITY OF EAGAN SEWER SERVICE PERMIT
3830 Pilot Knob Road
P.O. Box 21199 PERMIT NO.:
Eagan, MN 55121 DATE:
Zoning: No. of Units:
Owner:
Address:
Site Address:
Plumber:
I agree to comply with the City of Eagan Connection Charge: '7'r nn
Ordinances. Account Deposit:
Permit Fee:
Surcharge:
By Misc. Charges:
Date of Insp.: Total:
Insp.: Date Paid:
Use BLUE or BLACK Ink
u
I-
(r~nF~ For Office Use- -
~ r ttxr I f
ILA C1 ~`i
r^ n n~'".-
f Permit
City
of Ea I Permit Fee: J 1 / U
3830 Pilot Knob Road 2
Eagan MN 55122 Date Received: 'I> I
Phone: (651) 675-5675 I 1
Fax: (651) 675-5694 1 Staff: I
I I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
LOK 'f 3N-6? [Y3/7 H3 173 LA_[CfA5&4 r ` Unit
Date: Site Address:
t Name:-, 1`*►t c CS I Y`O ~~~r (1,64 Phone: A ! 5~? 2S9-
Residentl Q
Owner Address / City / Zip:
t
Applicant is: Owner Contractor
i Description of work: 5
I Type ofWork
Construction Cost;_
V, ew,
TL8 kcs~acint t, s
Company: Contact:
: ti
Contractor Address: N City
1Q- 75
State Zip: Phone . 6?--7q7
:
j~GS¢ _Ll -LeaaCertl Ic"f' ate - r
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
!O 1 Itf ~ / ~
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 inforination. Portions of-
the the information may be classified as 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 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.oooherstateonecall.org
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 State Building Code must be completed within 180
days of permit issuance,
x ~.k ~-.\p 5 x
Applicant's Printed Name Applicant's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA163440
Date Issued:09/01/2020
Permit Category:ePermit
Site Address: 4315 Clemson Cir B
Lot:7 Block: 2 Addition: The Trails Of Thomas Lake
PID:10-75865-02-070
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 - Residential Additions, Alterations
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 within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 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 -
Jeffrey A Carroll
4315 Clemson Cir B
Eagan MN 55122
(612) 807-7035
Sandau Construction
9025 Hwy 101 W
Savage MN 55378
(952) 403-9100
Applicant/Permitee: Signature Issued By: Signature