EA180937 - Plumbing - Water Heater - Issued Date 01/10/2023 PERMIT
City of Eagan • e , , Permit Type: Plumbing
3830 Pilot Knob Rd �-a� E AGAN Permit Number: EA180937
• O O
Eagan,MN 55122 •®-- ®--•
(651)675-5675 111111111111
www.cityofeagan.com a * E A 1 8 0 9 3 7
Date Issued: 1/10/2023
Site Address: 4158 Ethan Dr
Lot: 7 Block: l Addition: Oak Bluffs
PID: 10-53400-01-070
Use: * 10 - 53400 - 01 - 070 *
Description:
Sub Type: Water Heater
Work Type: Replace
Description:
Meter Size Meter Tyne Manufacturer Serial Number Remote Number Line Size
Comments:
Fee Summary: PL-Plumbing Permit Fee $64.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
Total: $65.00
Contractor: Owner: - Applicant -
Thomas J Sherek
4158 Ethan Dr
Eagan MN 55123-490
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 By': Signature
I For OfficeUise--
Q
-------
, I l� t�� I
,� � I Permit I
EAGAN
Permit Fee:
I
I Date Received: I
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 I I
(651)875-58751 FAX:(651)675-5694 Staff:
Email:buildinainsoections(&-citvofeaoan.com -----------------�
RESIDENTIAL MECHANICAL PERMIT APPLICATION
Date: J /O Site Address: �'Gi� —Unlit#:
Applicant is: ROwner ❑ Contractor
Name: ro-4. 7 a"04--- n
Homeowner Address: 6 / J�9 �e°r" Q'/
City:
State: Zip: t ��4 Phone: Email q/j �5;t e 114 1` • `�a �'
Type of Work _New _Replacement _Repair —Alteration —Remove
Description of work: t l a-ec r✓� e e
J` Furnace _Heat Pump
Description Air Conditioner Other
Air Exchanger
Company: Contact:
Mechanical Address: City:
Contractor
State: Zip: Phone: Email:
License#: Expiration Date:
RESIDENTIAL FEES
$150.00 New Residential(includes State Surcharge)
$65.00 Residential alteration,furnace,air conditioner,ductwork,or any combination(includes State Surcharge)
$100.00 Residential fireplace(s)(includes State Surcharge)
TOTAL FEES$
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.citvofeaaan.com/subscdbe.
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.
� L- < 1�%4X X
Applicant's Printed Name Ap licant's Signature
FOR OFFICE USE
Required Inspections: Reviewed By: Date:
Underground Rough In Air Test Gas Service Test In-floor Heat Final