EA180938 - Mechanical - Furnace - Issued Date 01/10/2023 PERMIT
City of Eagan ® m , Permit Type: Mechanical
3830 Pilot Knob Rd `.` % ': Permit Number: EA180938
AGA
Eagan,MN 55122 •--® --®®
(651)675-5675
111111111111
www.cityofeagan.com * E A 1 8 0 9 3 8
Date Issued: 1/10/2023
Site Address: 4158 Ethan Dr
Lot: 7 Block: t Addition: Oak Bluffs
PID: 10-53400-01-070
Use: * 10 - 53400 - 0 1 - 070 �K
Description:
Sub Type: Furnace
Work Type: Replace
Description:
Comments:
Fee Summary: ME-Mechanical Residential Alteration $64.00 0801.4088
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/Petmitee: Signature ssued B .Signature
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For Office Use
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0 �, I Permit#: l V
EAGAN
Permit Fee:
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Date Received: `G I
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 I I
(651)675-5675 1 FAX: (651)675-5694 Staff:
buildinainsaections(&citvofeaclan.com ------------------
RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: :° Z 3 Site Address: Ll �'�� � aN �/ Unit#:
Applicant is: Owner ❑ Contractor,(
Name: f G k1A ✓� �, e-��{i �-
Homeowner Address: Lf��d� G /1,G�� T city: / �Qi
State A1/VZi : Ski 7 Phone- Z§?o ail: -e
Type of Work —New Replacement _Repair —Rebuild _Modify Space _Work in R.O.W.
Description of work: Cuq/Tti'
Tankless Water Heater
�C
r Standard Water Heater Lawn Irrigation(_RPZ/ PVB)
Description Water Softener Add Plumbing Fixtures(_Main/ Lower Level)
Septic System Description:
New Abandonment Connection to City Water from Well
Company: Contact:
Plumbing Address: City:
Contractor
State: Zip: Phone: Email:
License#: Expiration Date:
RESIDENTIAL FEES
$150.00 New Residential or Connection to City Water(includes State Surcharge)
$65.00 Water Heater,Water Softener,or Water Heater and Softener(includes State Surcharge)
$65.00 Lawn Irrigation(includes State Surcharge)
$65.00 New fixtures,adding,altering,or removing piping(includes State Surcharge)
$65.00 Septic System Abandonment(includes State Surcharge) L
TOTAL FEES$ �� ,,
�
CALL BEFORE YOU DIG. Contact Gopher State One Call at(651)4540002 or www.aooherstateonecall.ora 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 at wtthout 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 plan
X , �Llellw-- X
Applicant's Printed Name Applicant's Signature
FOR OFFICE USE
Reviewed By: Date:
Meter Size(if applicable):
Required Inspections: Under Ground Rough-In Air Test Gas Test Manometer Final