EA184641 - Plumbing - Fixtures - Issued Date 06/16/2023 PERMIT
City of Eagan Permit"':
Plumbing
3830 Pilot Knob Rd ®®° ® ® ®®° Permit Number: EA184641
Eagan, MN 55122 ®®®® ®®®®
EAGAN
(651)675-5675 111111111111 IN 11111111111111111111111111111111
www.cityofeagan.com * E R 1 8 4 6 4 1 *
Date Issued: 6/16/2023
Site Address: 4252 Sun Cliff Rd
Lot: 2 Block: 5 Addition: Sun Cliff 1st
PID:10-72975-05-020 11111111111111111111111111 11M
Use: * 10 - 72975 - 0S - 020 *
Description:
Sub Type: Fixtures
Work Type: Replace
Description:
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:
Minnesota Rusco Kyle Thomas Mader
5010 Hwy 169N 4252 Sun Cliff Rd
Brooklyn Park MN 55428 Eagan MN 55122
(952)935-9669
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
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For Office Use
I Permit#: 184641 I
A Cam 70'k A
I Permit Fee: �� I
CEIVE 1 I
I
Date Received: I
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 CUN � 5 2023 1
(651)675-5675 1 FAX: (651)675-5694 Staff:
buildinainspectionsOcityofeapan.com 6Y; ------------------
RESIDENTIAL
----------------RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: 6/15/23 Site Address: 4252 Sun Cliff Rd Eagan, MN 55122 Unit#:
Applicant is: ❑ Owner 14 Contractor
Name: Kyle Mader
Homeowner Address: 4252 Sun Cliff Rd City: Eagan
State: MN Zip: 55122 Phone: 612-254-5322 Email: kelli@minnesotarusco.com
Type of Work, —New V( Replacement _Repair _Rebuild _Modify Space _Work in R.O.W.
Description of work: Direct replacement of existing shower wet space,wall surround, and plumbing fixtures.
Tankless Water Heater
Standard Water Heater Lawn Irrigation(_RPZ/ PVB)
De8cri tion Add Plumbing Fixtures�Main/ Lower Level)
p Water Softener
Septic System Description: Shower
New Abandonment Connection to City Water from Well
Company: MN Rusco Contact: Kelli Gugisberg
Plumbing Address: 5010 Hwy 169 N City: Eagan
Contractor State: Zip.. Phone:MN 55428 952-935-966 Email.. kelli@minnesotarusco.com
License#: PC805612 Expiration Date: 12/31/23
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.00pherstateonecall.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 Kelli Gugisberg X Ae4601gn
Applicant's Printed Name Applicant's ig ture
FOR OFFICE USE-
Reviewed By: Date:
Meter,Size Of applicable):
Required Inspections: Under Ground Rough-In Air Test Gas Test Manometer Final