EA179992 - Plumbing - Single Fam - Issued Date 11/07/2022 PERMIT
City of Eagan 4 Permit Type: Plumbing
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3830 Pilot Knob Rd �`., + ►,.�, Permit Number: EA179992
Eagan,MN 55122 EAGAN
(651)675-5675 111111111111
www.cityofeagan.com * E R 1 7 9 9 9 2
Date Issued: 11/7/2022
Site Address: 1025 Diffley Rd
Lot: 2 Block: 1 Addition: Kirchner Plaza
PID: 10-42100-01-020
Use: * 10 - 42100 - 01 - 020 *
Description:
Sub Type: Single Fain
Work Type: Replace
Description: add plumbing fixtures and water softner
Meter Size Meter Tyne Manufacturer Serial Number Remote Number Line Size
Comments:
Fee Summary: PL-Permit Fee $59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
Total: $60.00
Contractor: Owner: - Applicant -
Samuel W&Melba R Johnson
1025 Diffley Rd
Saint Paul MN 55123-450
This permit shall be null and void if work does not start within 180 days of issuance,or if work is suspended for 180 days or more after
started.
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.
Applicant/Permitee: Signature ssued B : Signature
----------------,
I For Office Use I
I Permit#: 179992
•..• •..• CEIVE 1
i Permit Fee: $60
Y I
I
OCT 3 1 2022 1 Date Received: I
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 I I
(651)675-5675 1 FAX: (651)675-5694 �Y� I Staff: I
buildinginsoections -citvofeagan.com ------------------
RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: 0 / �a Site Address: 10 a 5 i9► *l e y Rd mn SS/,7Jnit#:
Applicant Is: Owner ❑ Contractor
Name: M 00101 k ► G w s le)�
Address: l ( City: R
State: M Zi S �� Phone:Wq Sg
7P 00W Email: /'ot!tit 01,7
i�• Y x�?�t��Y t v6
New x Replacement _Repair _Rebuild _Modify Space _Work in R.O.W.
Description of work:
Tankless Water Heater
Lawn Irrigation(_RPZ/ PVB)
Standard Water Heater
Add Plumbing Fixtures Main/X Lower Level)
Water Softener _
; : . Description: re v, e X►f f%y �ra f�r�
4<x ' Septic System
New _Abandonment Connection to City Water from Well
Company: ( - Contact:
Address: City:
State: Zip: Phone: Email:
License#: Expiration Date:
RESIDENTIAL FEES
$100.00 New Residential or Connection to City Water(Includes State Surcharge)
$60.00 Water Heater,Water Softener,or Water Heater and Softener(includes State Surcharge)
$60.00 Lawn Irrigation(includes State Surcharge)
$60.00 New fixtures,adding,altering,or removing piping(includes State Surcharge)
$115.00 New Septic System(includes County fee and State Surcharge)
$60.00 Septic System Abandonment(includes State Surcharge)
TOTAL FEES$
CALL BEFORE YOU DIG. Contact Gopher State One Call at(651)454-0002 or www.gooherstateonecall.org for protection against underground utility
damage. Contact Gopher State One Cell 48 hours before you intend to dig to receive locates of underground utilities.
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 1 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.
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Applicant's Printed Name Applicant's Signature
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