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1084 Kirkwood DrRESIDENT / OWNER Cagan, MN 55123 Name: 6512853189 lone: Address / City / Zip: CONTRACTOR Name: ___ NORB OM PI UMBIN.G Ca,_ License #: O(' ( 5� FM Address: (612) 8274033 City: 2905 GARFIELD AVE SO State Zip: MINNEAPOLIS, MN 55408 Phone: Contact Person: TYPE OF WORK — New ,x Replacement Repair Rebuild Modify Space Work in R.O.W. Description of work: replace/ Wai heafer PERMIT TYPE RESIDENTIAL 1 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, 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 (includes $.50 State Surcharge) Fixtures, Septic System Abandonment, Water Turnaround* (includes $.50 State Surcharge) (add $165.00 if a 5/8" meter is required) New ($10.00 per as built) (includes County fee and $.50 State Surcharge) burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) TOTAL FEES $ �` €ity of Eaaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 Date: 1 o12.ce( Tenant: 2009 RESIDENTIAL PLUMBING PERMIT APPLICATION Site Address: _ Diana Scott 1084 Kirkwood Drive 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 pen 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 'Jeyffr 'Jorb1 am Applicant's Print Name Date Received: A• icant's Signeeure Permit #: /Z Permit Fee: 1.5*" 00 Staff: L Suite #: FOR OFFICE U CITY p. ,EAtfA k WATER SERVICE PERMIT 3 ` f Knob- 4C PERMIT NO.: 4644 MN 55122 DATE: 4/11/ 83 Zoning: RII No. of Units: 1/2 duplex Owner: Blilie Construction Co Address: Site Address: 1084 Kirkwood Dr, L22 B2 CM East I Plumber: David & David (Southtown) Meter No.: Connection Charge: 450.00 pd Size: Account Deposit: Reader No.: Permit Fee: 10.00 pd 1 agree to comply with the City of Kagan Surch4 1 , 50 pd Ordinances. Charge 3" i 60000 pd meter Total: By 0/LI< SD/ Date Paid: Dote of Insp.: 4' - Insp.: CITY 09.1.AGAN SEWER SERVICE PERMIT 3795 f 11ot 'Road PERMIT - NO.: 5731 Eagan, MN 55122 i DATE: .. 4/ 11/83 Zoning: 1;TT ? j `' }' . / N�. of Unfit; �.� lit duP.ley. Owner. R11141 (`nnAiriirti;nn Cn J • I Address: Site Address: 10/14 Ri rktJDnri T)r I T.77 R) (M _.J _flaw- T Plumber: .THAN (i/&` $V d- ESoutlrtewn) 1 I agree to eomp w 2/ 34396 , '' 1 100.00 pd Ordinances. ` ... the City of Eagan Connection Charge: 425.00 pd Account Deposit: i Permit Fee 1n rg Sn d By � , / Misc. Charges: P Dote of IndlL) /el Total: Insp.: %— ir- w b Date Paid: PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA175984 Date Issued:04/26/2022 Permit Category:ePermit Site Address: 1084 Kirkwood Dr Lot:22 Block: 02 Addition: Ches Mar East 1st PID:10-17150-02-220 Use: Description: Sub Type:Water Heater 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 - Emiliano F Monroy 1084 Kirkwood Dr Eagan MN 55123 Champion Plumbing Llc 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 Applicant/Permitee: Signature Issued By: Signature