2156 Waterlily Ln RECEIVED Use BLUE or BLACK ink
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My Permit
j Permit Fee: CYO 6 0"
3830 Pilot Knob Road I I
Eagan MN 55122 I Date Received: �4'��
Phone:(651)675-5675 Staff:
Fax: (651)675-5694 ___
2016 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: 516!2016 Site Address: 2156 Waterlily Lane
Tenant: Suite#:
Resident/Owner
Name: Padma Adella Phone: 651-261-0229
Address/City/Zip: 2156 Waterlily Lane, Eagan MN 55122
Name: Metro Heating & Cooling License#: PM058051
Contractor
Address: 255 Roselawn Avenue East#41 City: Maplewood
State: MN Zip: 55117 Phone: 651-294-7798
Contact: Micah Email: micah@metroheating.net
Type of Work —New -/ Replacement _Repair —Rebuild —Modify Space _Work in R.O.W.
Description of work: replace existing water heater
77- RESIDENTIAL
Water Heater
Water Softener
Lawn Irrigation(_RPZ 1_PVB)
Permit Type
Septic System Add Plumbing Fixtures L_Main/_Lower Level)
New Water Turnaround
Abandonment
RESIDENTIAL FEES:
$60.00 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.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.
x Micah Vail x
Applicant's Printed Name Applicant's Signature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Rough-In Air Test Gas Test Final
Meter Related<Items: Meter Size Radio Read Manometer Staff: