4603 1_2 Penkwe Way
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• :Te;AllAGAN WATER SERVICE PERMIT
Knob Reed ' PERMIT NO 4 7 4 7
Illeaer, MN 55122 DATE -31 -
2nii�ig; No. of Units:
' Thompson Lakes Vie*
=e l dress: 460 Penkoe Way, L3 B13 Johnny bake Ridge
= ° Pkariber: Wenzel
Meter No.: Connection Charge:
450.00 pd
Account Deposit:
R#iader No.: Permit Fee: 10.00 pd
I agree to comply with the City of Eagan Surcharge: " 50 pd
ordinances. Misc. Charges: 60.00 pd meter
Total:
By Dote Paid:
Date of Insp.: Insp.•
CITY SEWER SERVICE PERMIT
br9sqrgicjototi Road
Eagan, MN 55122 PERMIT NO: 5�3 li
Zoning: r. -
*No. of Ail `
Owner: t • it 1, 8011 e = Div
I , Address:
Site Address: 4 t r . • �; , D J
• t Bke
Plumber: We z Wallimmemew
5 -6-83 35708 100.00 pd
• t epee to comply with the City of Eagan Connection Charge:
Account beposit:
Permit Fee: 10 . QQ nd
By Surcharge:
Y Misc. Charges:
Dote of 1 ,: ;t ' 1"P9/ Total:
Insp.: Dote Paid:
n
s , 1 � " ) ,- ` ,
F
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► „ 1 4143 �' 7 s
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t��6 O��� t� RECEIVED , P�,��:
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� 12 14 � P�,,,�t��:: 34 �
3830 Pilot Kr�ob Road ��� ��� Z�
Eagan MN 55'1�2 j Date Received: i
Phone:(651j 6Z5-S675 1 �
Fax;(�1�6T5-5694 1 Staff: 1
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. . . . ... . . . . . 1�� . - ��.���J . .
2014 RESIDENTIAL' BUILDiNG PEI3MIT A�PLICATI4N
��: �--1�yt� s��,�a��: �-r��1-.- �6�, � '�� p��w�. w� u���:
Name:L/G?fr!?Y�'� ���- ��tv�7 h�t— �Ph�one:
Residen�T
+�wn�r aad�es��c�r t z�p: ,�'�"'�� �''1�
Applicant is: Owner � Contractor
C)esc,riptionofwork: ��� c��� � ��' ��o��
�yp�of Wark e
Construc#ion Cos�: ��',!�!J � Mu�i-Famiiy Building:(�es .� /No_�
� / .•�'�G,,• �' .-
Company:lif�YLc���;�.d1%s/r�-G.�t�/S `�. Contact t�j�''�'t /�E�iJ�'�
' Address:���j� Z.r�-1��� �s��- L�!�'3�'� /� City:��'�` ��G�J/'�.;�
COl1#f'�C�4C �
1
State:E�Ta p: ��.�3�j r Phone:�j�J�7"��Ernail:t��r+r�fl Jr!�3�5fi G c3Yl'�+���7�v v .�-
�C@11S$#;i✓L. �d� b �7� "�y!G—�r�
Lead cert�cate#:sV�a.-�°�- ..- r�1i. —l
If the project is exempt from iead certi�cation,please expfain why: (see Page 3 for adclitional inforrnation)
COMPLETE THIS AREA ONLY IF CONSTRUC7fNG A NEW BUi�DtNG
tn the last 92 maM , the City of Eagan�issued a permit for a similar plan based on a master ptan?:
Yes i,No If yes,date and addr ' f master plan:
L1cen�ed Plumber: Phot�e: `
AAechanical Contractor: ,
Sewer&Water Gorrt r. Phone:_ „�_
�tE�t7'�:- s ancT sujnpc�rdr��tlocumer�fs�iarf yocr�ubm�t are�nsia[�red ta ke p�bl,c��r�tat�or� -I°�r�r���f>
� r�fr�ni�ratiot�m�}r b��f�ss���s non p�,�ili�if you pr�vPtle sp�clfic rseaso,ns i�rat���r/r�pe�arr�;�ie G�,i;#o ''
cc��r�l�rd�fhaft are�de se�ea�ts.;
CALL S�FORE YOU DIG. ca���a�ner scat�o�e ca�r at�ss��asa-000a�or pr�tea►on agai��der9���y aama�e. can 4s na,r�
before you-intend to dig#o receive locates af underground utilities. www.qoohersfateonecatt.arp
I hereby ackno�nAedge that this irifoRna#ion is comp�#e and aasurate;#hat the v+rorlc will t�in confo�rnanca witt►�e ordinar�and codes af the City of
Eagan;#hat 1 undetstar+d this is not a permit, bui only an applicafiort for a pemtit. atid wwk is[rot to atalt wiihout a pe►�r►it;tltaf ihe work wit4 be in
accardance with the approved ptan in the t�se of wvrtc which requi�a�view and approvat of plans.
Exterior work author�i by a buiiding permit iss�d in accordance with the M€nnesota Stats iding Cnde must be com�bed within 180
days of petcrtit issuanee.
x ��
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Apptican�s Printed Name • nt's Signature
' Page 1 of 3