EA184635 - Plumbing - Single Fam - Issued Date 06/15/2023 PERMIT
City of Eagan ® ® Permit Type: Plumbing
3830 Pilot Knob Rd ®®®® ° ®®®®®® Permit Number: EA184635
Eagan,MN 55122 EAGAN
(651)675-5675 1111111111111111111111111111111111111111111111111
www.cityofeagan.com * E R 1 8 4 6 3 5 *
Date Issued: 6/15/2023
Site Address: 3695 Birchpond Rd
Lot: 8 Block: 1 Addition: Blackhawk Hills 2nd
PID:10-143 81-01-080
Use: * 1 0 — 1 4 3 8 1 — 0 1 — 0 8 0
Description:
Sub Type: Single Fam
Work Type: Replace
Description: install new sink, and fridge water line,move 2nd
floor waste
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:
Nordic Plumbing and Heating LLC Michael J Shea
2078 Cty Rd F East 3695 Birchpond Rd
White Bear Lake MN 55110 Eagan MN 55122
(715)690-4960
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
----------------
For Office Use
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Date Received: b l I I
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 1 I
651 675-5675 FAX: 651 675-5694 Staff:
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RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: Site Address: ��2 G4�t b Unit 0:
Applicant is: ❑ Owner ❑ Contractor
Name: &J I& R
Homeowner Address: VP-/5_ f/\ (�1f/��� 1l��D Ci 2AaaA
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State: IO Zip:55121- Phone: Email:
Type of Work New Replacement _Repair _Rebuild Modify Space —Work in.RO.W.
Description of work: L L'O S ' rWATUL G� E
Tankless Water Heater
Standard Water Heater Lawn Irrigation(—RPZ/ PVB)
Description Water Softener Add Plumbing Fixtures(_Main/ Lower Level)
Septic System Description:
New Abandonment Connection to City Water from Well
Company: Ayabi6 Pctfg17�,��-qs� u� Contact 4(�VO S LL)A��
Plumbing Address: 2 J�� a. U E C City: W kA.P 6.tv— Izee
Contractor out
State: N rJ Zip: )D Phone: o" dEmail: �, /�@ t'C r t VV46 1
License#: QD(y�ZI D Expiration Date: Z4,61 D
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.aooherstateonecall.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 o i
x o(h &&LUND
Applicant's Printed Name I nt' i ature
FOR OFFICE USE
Reviewed By: Date:
Meter Size(if applicable):
Required Inspections: Under Ground Rough-in Air Test Gas Test Manometer Fina"