EA182624 - Plumbing - Water Heater - Issued Date 05/02/2023 PERMIT
City of Eagan ® ® , ° Permit Type: Plumbing
3830 Pilot Knob Rd '.® ® ® °a° Permit Number: EA182624
Eagan,MN 55122 •--® mm-aEAGAN
111111111111
(651)675-5675 � * E R 1 8 2 6 2 4
www.cityofeagan.com
Date Issued: 5/2/2023
Site Address: 3771 Grey Dove Lane
Lot: 2 Block: 19 Addition: Town View 1st
PID:10-77100-19-020
Use: * 10 - 77 100 — 19 - 020 *
Description:
Sub Type: Water Heater
Work Type: Replace
Description:
Meter Size Meter])Me 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:
Appliance Connections Inc Christyna H Jarosh
12850 Louisville Road 3771 Grey Dove Ln
Shakopee MN 55379 Saint Paul MN 55122-412
(952)445-4803
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
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1 For Office U I
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♦°� •` • 1 Permit#.
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I Permit Fee:
Date Received: I
3830 PILOT KNOB ROAD I EAGAN,MN 55122-1810 I I
(851)675-56751 FAX:(661)875-5894 Statf:
bUIIdInaIn8oecdons0c–Wofeaaan Com ----------------
RESIDENTIAL PLUMBING PERMIT APPLICATION
Date:05/02/23 SiteAddress:3771 GREY DOVE LANE Unita
Applicant is: ❑Owner la Contractor
Name:CHRISTYNA JAROSH
Hfyrheowner Address:3771 GREY DOVE LANEcity: EAGAN
$tate:MN ZI :55122 Phone:6513024490 Email: N/A
llype;of Work —New V Replacement —Repair _Rebuild —Modify Space —Work in R.O.W.
Description of work: REPLACE WATER HEATER
—Tankless Water Heater
Standard Water Heater --Lawn irrigation(—RPZ/ PVB)
�SOrIO Water.Softenar _. Add Plumbing Fixtures(_Mein!_Lower Level)
_Septic System Description:
New Abandonment Connection to City Water from Well
Company:
APPLIANCE CONNECTIONS INC Contact:JAMIE RI'PPEL
w '�
PIulmbiftg Address:12850 LOUISVILLE ROAD ��,. SHAKOPEE
�100tf8CtO1"' MN 5553799524454803 OFFICE@APPLUWCECONNECTIONSINC.COM
States Zip. Phone: Email:
License#: PM057209 Expiration Date: 12/31/2024
RESIDENTIAL FEES
$150.00 New Residential or Connection to City Water pncludes State Surcharge)
$55.00 Water Heater,Water Softener,or Water Heater and Softener(includes State Surcharge)
$65.00 lawn irrigation(includes State Surcharge)
$65.00 Newfixtures,ending,altering,or removing piping pncludes State Surcharge)
$85.00 Septic p System Abandonment pncludes State Surcharge) 65.0U
TOTAL FEES$
CALL BEFORE YOU DIG, Contact Gopher State One Cell at(851)454-0002'or www.aooherstateonecall.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 Clty of
Eagan;that i underatehd this Is not a permit,but only an application for permit and work is not to start without a permit;that the work-Wilt be in
ar;Cordance with the approved plan In the 0860 of work which requires a review and approval of plans.
xJAMIE RIPPEL /�
Appilcant's Pointed Name x r
App call tors Signa"tuun
FOFf OFFICE USE,
Ftsv)ewdt!By^ Date:
Meter Site(if appltceble)s'
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