EA180960 - Plumbing - Fixtures - Issued Date 01/13/2023 PERMIT
City of Eagan , , ° ° Permit Type: Plumbing
3830 Pilot Knob Rd °°® ° ° °.' Permit Number: EA180960
Eagan,MN 55122 EAGAN
(651)675-5675 111111111111
www.cityofeagan.com * E R 1 8 0 9 6 0
Date Issued: 1/13/2023
Site Address: 3939 Thames Ave
Lot: 21 Block: 3 Addition: Coventry Pass
PID: 10-18400-03-210
Use: * 10 - 18400 - 03 — Z 10 �K
Description:
Sub Type: Fixtures
Work Type: New
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: - Applicant - Owner:
Minnesota Rusco Louis E&Judith A Gibbons
5010 Hwy 169 N 3939 Thames Ave
Brooklyn Park MN 55428 Saint Paul MN 55123--390
(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 slued B :Signature
r----------------
For Office Use
Permit* /�DEAGAN 1 1 `�
I
Permit Fee: �y
I
Date Received: I
3830 PILOT KNOB ROAD I EAGAN,MN 55122-1810 I
(651)675-5675 i FAX: (651)675-5694 ff
�—Sta --------------j
buildinainsr)ections(&-cityofeagan.com
RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: 1/12/23 site Address: 3939 Thames Ave Eagan, MN 55123 Unit#:
Applicant is: ❑ Owner 14 Contractor
Name:
Judith Gibbons
Homeowner Address: 3939 Thames Ave city: Eagan
State: MN Zi : 55123 Phone: 651-687-0660 Email: bagboy66@comcast.net
Type of Work —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 Lawn Irrigation(_RPZ/ PVB)
Description Water Softener Add Plumbing Fixtures(/Main/ Lower Level)
Septic System Description: Shower
Connection to City Water from Well
New Abandonment
Company: MN Rusco Contact: Kell! Gugisberg
5010 Hwy 169 N New Hope
P umbing Address: city:
Contractor MN 55428 952-935-966£ kelli@minnesotarusco.com
State: Zip. Phone: Email.
License M 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)
$66.00 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 Cali at(651)454-0002 or www.aooherstateonecall.oro 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 kea 04ggd6oe
Applicant's Printed Name Applicants SAnagirs
,FOR OFFICE.USS
Reviewed By: Date:
Alletersi;e;(If applicabie}
ih
Required Inspections: Under Ground . Rough-in Air Test Gas Test Manometer Final