EA180738 - Plumbing - Fixtures - Issued Date 12/27/2022 PERMIT
City of Eagan , , , , Permit Type: Plumbing
3830 Pilot Knob Rd ; EAGAN Permit Number: EA180738
Eagan,MN 55122 •--- -
(651)675-5675 111111111111
www.cityofeagan.com * E R 1 8 0 7 3 8
Date Issued: 12/27/2022
Site Address: 2184 James St
Lot: 5 Block: 6 Addition: Oak Cliff
PID: 10-53550-06-050 1 11T 111111111111111111111111111111 IR 11111111 1�11 11111 111M
Use: * 10 - 53550 - 0E - 0S0
Description:
Sub Type: Fixtures
Work Type: Alteration
Description: Bathroom
Meter Size Meter Tvne 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: - Applicant - Owner:
Minnesota Rusco Larry W Puzic
5010 Hwy 169 N 2184 James St
Brooklyn Park MN 55428 Saint Paul MN 55122--233
(952)935-9669
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.
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Applicant/Permitee: Signature slued B Signature
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For Office Use I
I Permit#: 1
EAGAN
0 I
V I Permit Fee: b I
Date Received:ECEIE
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3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 -: 2 1
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651 675-5675 1 FAX: 651 675-5694 1 Staff:
buildinginsgections(a)cityof agan.com -----------------�
RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: 12/20/22 Site Address: 2184 James St Eagan, MN 55122 Unit#:
Applicant is: ❑ Owner 14 Contractor
i
Name: Larry PUZIC
t Homeowner Address: City: g 2184 James St Eagan
State: MN Zig. Phone Email. p �g
55122 952-457-5617 Iw uzic mail.com
Type of Work —New Replacement —Repair _Rebuild _Modify Space _Work in R.O.W.
Description of work: Direct replacement of existing shower wet space,wall surround,and plumbing fixtures.
Tankless Water Heater
Standard Water Heater Lawn Irrigation (_RPZ/_PVB)
Description Add Plumbing Fixtures(�Main/ Lower Level)
p Water Softener
Septic System Description: Replace Shower
New Abandonment
Connection to City Water from Well
Company: MN Rusco Contact: Kelll Gugisberg
Plumbing` Address: 5010 Hwy 169 N City: New Hope
Contractor State: Zip.. Phone:MN 55428 952-935-966 Email. kelli@minnesotarusco.com
License#: PC749301 Expiration Date: 12/31/23
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.aopherstateonecall.org for protection against underground utility
damage. Contact Gopher State One Call 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 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 Kelli Gugisberg X 0441�' L;e
Applicant's Printed Name Applicant's Signat6re
FOR OFFICE USE
Reviewed By: Date:
Meter Size(if applicable):
Required Inspections: Under Ground Rough-In Air Test Gas Test Manometer Final