EA181220 - Plumbing - Fixtures - Issued Date 02/02/2023 PERMIT
City of Eagan Permit Type: Plumbing
3830 Pilot Knob Rd °°` o S ®®' Permit Number: EA181220
Eagan,MN 55122 •-
(651)675-5675 EAGAN
www.cityofeagan.com * E A 1 8 1 2 Z 0
Date Issued: 2/2/2023
Site Address: 4673 Jackstone Pt
Lot: 3 Block: 08 Addition: Ridgecliffe 4th
PID: 10-63983-08-030 11111111111 IN 111111 11111M
Use: * 10 - 63983 - 08 - 030 *
Description:
Sub Type: Fixtures
Work Type: Replace
Description: tub to tub replacement
Meter Size Meter lype 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:
Modern Plumbing LLC Aaron Schroeder
16373 226th Ave NW 4673 Jackstone Pt
Elk River MN 55330 Eagan MN 55122
(763)639-1632
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 sued B :Signature
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3830 PILOT KNOB ROAD l EAGAN.Mid 351112 aio
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RESIDENTIAL PLUMBING PERMIT APPLICATION
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aamn schroeder
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New ✓Re*MMerd _Repair _ReWM —Modity Space Work In R0.W
tub to tub replacement
of Waft
Tankhm Water HeaW
Lawn kriga llon L RPZ/ PVS)
Sftndard Water Header
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Wates Softer Add Plumbing FbMm(_Maur/Lower Levu
' on:tub to tub replacement
New
—Abandonment
m on to Ctty Water&M Well
Modem Plumbing, LLC c,ntct Vince
p�MOO noAdam:.
16373 226th ave nw elk river
CO sub:mn zip:55330 763-639-1632 Phanec- Err a� vince@modemplumb.corn
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RESIDENTIAL FEES
E15tl.OD Now ResldenVW or Cthnrtedon to CRy Water(h tdes Slate Surcharge)
SUM Wafer Heater Wafer Softener.or Water HeatermW Softener(indudes Stere Studtargs)
Lawn kfta&m(includes State Surdarge)
SUM Mew foftm adding.aRatg,or rrermvirtg piptng tirn udw State Sruchame)
U5.OD Septic System Abandonowd Cutdudw Shft SumhaMe)
TOTAL FEES$65
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CALLBEFOMYOUMM Contact gopher SUM Om Call at(651)454 MM orvmw amtorstaftortecAamfor
damage. Contact Gopher State One Call 46 hours bafbm you interni to dig to receive locates of underground utllltles.
I hereby acknowledge that fhb 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 without a pert that the work will be in
accordance with the approved plan In the case of work which requirea a review and approval of plans.
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