EA182123 - Plumbing - Fixtures - Issued Date 04/07/2023 PERMIT
City of Eagan , , Permit Type: Plumbing
3830 Pilot Knob Rd ,,�;; ;;:, Permit Number: EA182123
Eagan,MN 55122 EAGAN
(651)675-5675
www.cityofeagan.com * E R 1 8 2 1 2 3
Date Issued: 4/7/2023
Site Address: 1643 Mallard Dr
Lot: 27 Block: 1 Addition: Mallard Park 2nd
PID:1047251-01-270
Use: * 10 - 4725 1 - 0 1 - 270 *
Description:
Sub Type: Fixtures
Work Type: New
Description: Basement finish
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 -
Jessie Ann Dormody
1643 Mallard Dr
Eagan MN 55122
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
f ----------------
For
---------For Office Use
Permit#: I
EAGAN
jPermit Fee:
Date Received: I
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 l j
(651)675-56751 FAX: (651)675-5694 Staff: I
buildinainspectionsocitvofeaoan.com -----------
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RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: Site Address: C� `'l3 `Au- tz-r) Unit M
Applicant is: Owner ❑ Contractor
r
Name:
HomeownerAddress: � � '(ac �,4e-✓J 0 2 City: E c "n��c
State: Zi : :551 Z Phone: SD7 mail: c
Type of Work New _Replacement _Repair _Rebuild odify Space _Work in R.O.W.
Description of work: %(A
Tankless Water Heater
Standard Water Heater Lawn Irrigation(_RPZ/ PVB)
Description Water Softener Add Plumbing Fixtures Main/_A Lower Level)
Septic System Description: '
M� -rt-i
NewAbandonment
Connection to City Water from Well
[ 6
Company: HOS OVAy/- Contact:
Plumbing Address:SlYl`G7- 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)
$55.00 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.aogherstateonecall.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—C--1 '51. E- Dy r x
Applicant's Printed Name Ap can 's Signature
FOR OFFICE USE
Reviewed By: Date:
Meter Size(if applicable):
Required Inspections: Under Ground Rough-In Air Test Gas Test Manometer Final