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For Office Use
o EAGAN
aqye�� v,e�rt Permit#:
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ermit Fee: �f�
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MAY ,L 0 2018 Date Received: ,5.10 18
3830 PILOT KNOB ROAD I EAGAN,MN 55122-1810
(651)675-5675 I TDD:(651)454-8535 I FAX:(651)'675-5694
buildinciinspectionsacityofeagan.com Staff:
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2018 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date; JSite Address:, 36)4--;) C�„'v��1�` �+` F� eArv,
Tenant: \)\. o\( `"
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' ,e� eWkf4 ®' �4 � Name: tr' 7
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to N � } Address/City/Zip: _ t lA_ ! �."
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`-� N' x'7` Name: MILBERT COMPANY dba CULLIGAN WA) ER �`
+g�� License#: WC641376
441'V140474 7''44A-t Address: 1801 50TH STREET EAST
` � a #:; City: INVER GROVE HEIGHTS
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0,,,..:,1!.4.,•:q,,,,' r „� k State: MN . Zip; 55077 Phone: 651-451-2241
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't>� a Contact: BILL MILBERT Email: gloria.abas@culligan4water.com
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,, „,,,,,...,,f,e,,,.4 ei,,ti,, 'i,- ,,,..,-- , .,. A.,.: New _Replacement Repair Rebuild Modify Space Work in R.O.W.
� etV =, � � ,-.- Description of work:
' g �, ''�'r RESIDENTIAL
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%,,, ,0 Water Heater
44N-'.:: s� ' a jr 1'ti Lawn Irrigation( RPZ/_PVB) X Water Softener
errnit�Ty
{r„fn {;r ,, 4,:,4,z,,,../ Septic System _Add Plumbing Fixtures( Main./ Lower Level)
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tt ` if ' New Water Turnaround
,L `r{c4'_W<a"i < Abandonment
RESIDENTIAL FEES: _- _ ....--.�..._,. -----
$$0.00 Water Heater,Water Softener, or Water Heater and Softener(includes State-Surcharge) ~
$60.00 Lawn Irrigation (includes State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment,Water Turnaround*(includes State Surcharge)
`Water Turnaround(add$280.00 If a 3/4"meter is required)
$115.00 Septic System New(Includes County fee and State Surcharge) TOTAL FEES $ 60.00
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.gopherstateonecall.orq
• You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.citvofeagan,com/subscribe.
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 en application for a permit, and work is not to start without a permit; that the work will be in
ac orda'cewthe approved pan In the case of w. k which requires a review and approval of plans.
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