EA182562 - Plumbing - Single Fam - Issued Date 04/28/2023 PERMIT
City of Eagan ® , Permit Type: Plumbing
3830 Pilot Knob Rd ,®�;® ;;�, Permit Number: EA182562
Eagan,MN 55122 ®® EAGAN
(651)675-5675 111111111111
www.cityofeagan.com * E R 1 8 2 5 6 2
Date Issued: 4/28/2023
Site Address: 3696 Ashbury Rd
Lot: 26 Block: l Addition: Blackhawk Glen
PID:10-14350-01-260 11111111111111111111 IN 111111111111111111111 11111M
Use: * 10 - 14350 - 0 1 - 260 *
Description:
Sub Type: Single Fam
Work Type: Alteration
Description: Washer outlet box installation
Meter Size Meter Tvue 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 -
Han Seung Lee
3696 Ashbury Rd
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 "sZed B : Signature
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For Office Use r I
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Permit#: �/
EAGAN
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e®®• ®®®r Permit Fee:
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Date Received: I
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 I I
(651)675-56751 FAX:(651)675-5694 I Staff.
buildinninspectionso_cityofeagan.com 1-----------------J
e�, RESIDENTIAL PLUMBING PERMIT APPLICATION
Date 99 AP �23 Site Address:R i 61 ���9 Unit#:
Applicant is: MOwner ❑ Contractor
Name: &A
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Homeowner Address:t9 b4
A( F1 city: a�a� AQ
Stat Zi Phone: 9:= C2 Frail: '1`� �`� 'LO6
Type of Work —New _Replacement —Repair _Rebuild —Modify Space —Work in R.O.W.
Description of work:
Tankless Water Heater
Lawn Irrigation(—RPZ/ PVB)
Standard Water Heater
�Add PlumbingFixtures(—MainVLowerLevel)Water Softener Description:WAA 19-r- 4sAchV f &k1g(
JVl
Septic System
Connection to City Water from Well
New Abandonment
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)
$65.00 Septic System Abandonment(includes State Surcharge)
TOTAL FEES$
CALL BEFORE YOU DIG. Contact Gopher State One Call at(651)454-0002 or www.gopherstateonecall.org 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 withthe approved plan,in the case of work which requires a review and approval of plans.
X thy� S') \ 151 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