EA180873 - Plumbing - Single Fam - Issued Date 01/10/2023 PERMIT
City of Eagan , , Permit Type: Plumbing
3830 Pilot Knob Rd ,e.; 1 % Permit Number: EA180873
Eagan,MN 55122 • - a EAGAN
•••• ---•
(651)675-5675 1111111111111111111111111111111111111 1111H
www.cityofeagan.com * E A 1 8 0 8 7 3 *
Date Issued: 1/10/2023
Site Address: 3691 Cardinal Way
Lot: 4 Block: 1 Addition: Lexington Place South 2nd
PID: 10-45061-01-040
Use: * 10 - 45061 - 01 - 040 *
Description:
Sub Type: Single Fam
Work Type: Replace
Description: direct replacement of existing shower wet space,
wall surround and plumbing fixtures
Meter Size Meter kpe 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: - Applicant _ Owner:
Minnesota Rusco Linda H Baulos
5010 Hwy 169 N 3691 Cardinal Way
Brooklyn Park MN 55428 Eagan MN 55123
(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.
Applicant/Permitee: Signature ssued B :Signature
-----------------
For
--------For Office Use I
ooe e ! e® I 180873
I Permit#:EAGAN 1
®�•s •®tee 1I
1 Permit Fee:
Date Received: 1/5/23 �
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 I I
I
(651)675-56751 FAX: (651)675-5694 Staff: 1
buildinginspections(&-cityofeagan.com -----------------
RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: 1/5/23 Site Address: 3691 Cardinal Way Eagan, MN 55123 Unit#:
Applicant is: ❑ Owner 14 Contractor
Name: Linda Baulos
Homeowner Address: 3691 Cardinal Way city: Eagan
state: MN ZiD. 55123 Phone: 651-341-8977 Email: Ibaulos@hotmail.com
T�fp@"oMork —New V( 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
Description Water Softener Lawn Irrigation(—RPZ/ PVB)
V( Add Plumbing Fixtures C_Main/ Lower Level)
Septic System Description: 2nd floor: Shower & sink
Connection to City Water from Well
New Abandonment
7,777 — —
Company: MN Rusco contact: Kelli Gugisberg
Plumbing Address: 5010 Hwy 169 N City: New Hope
Contractor I State: MZip.. Phone: Email.. kelli@minnesotarusco.com
55428 952-935-9665 kelli minnesotarusco.com
License#: PC749301 Expiration Date: 12/31/23
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)
TOTAL FEES $
CALL BEFORE YOU DIG. Contact Gopher State One Call at(651)454-0002 or www.00aherstateonecall.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 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 ,!ta&
Applicant's Printed Name Applicant's Obnaffure
FOR OFFICE USE
Reviewed By: Date:
Meter Size Of applicable):
Required Inspections. Under Ground Air Vest Gas Test Manometer !' Final